Outcomes of cardiac surgery in the elderly.
The elderly represent a rapidly growing and substantially under-treated sector in industrialized countries, with coronary artery disease and degenerative aortic stenosis rampant. The proportion of elderly patients undergoing cardiac surgery is rising steadily and outcomes continue to improve with the refinement of operative techniques and perioperative care. Advanced risk stratification models, such as the logistic European System for Cardiac Operative Risk Evaluation now offer validated prediction of operative mortality in these high-risk patients. Current trends towards off-pump coronary artery surgery, hybrid revascularization and mitral repair may have advantages in the elderly, who often have more diffuse cardiovascular disease and a lower tolerance to intervention. Recent advances may also provide surgical options for the emerging epidemics of cardiovascular disease affecting the elderly, atrial fibrillation and heart failure.
Drury
Nigel E
NE
Papworth Hospital, Department of Cardiac Surgery, Cambridge CB3 8RE, UK. nigeldrury@gmail.com
Nashef
Samer A M
SA
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001024:Aortic Valve Stenosis / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000592:standards / Q000706:statistics & numerical data; D015897:Comorbidity; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D006331:Heart Diseases / Q000453:epidemiology / Q000601:surgery; D006349:Heart Valve Diseases / Q000453:epidemiology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D009204:Myocardial Revascularization; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents