title: Benefits of cardiac surgery in octogenarians--a postoperative quality of life assessment.
abstract: OBJECTIVE
  Assessment of postoperative quality of life in patients over 80 years after cardiac surgery including coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and combined procedures.
  
  
  METHODS
  Quality of life of n=136 patients over 80 years at operation (82.3+/-2.1 years), undergoing isolated CABG in 61 patients (45%), isolated AVR in 34 patients (25%) and a combination of CABG and AVR in 41 patients (30%) between January 1999 and December 2003 was reviewed. Preoperatively 66.2% presented in NYHA-class III/IV or CCS-class III/IV. Mean ejection fraction (EF) was 59.5%+/-14.0 (range 25-90%). Quality of life assessment was performed via a Seattle Angina Questionnaire. Follow-up was 100% complete for a total of 890 days (69-1853 days).
  
  
  RESULTS
  Five-year survival was 70% for the CABG group, 75% for the AVR group and 65% for the CABG/AVR group. Quality of life was remarkable in all of the three groups after surgery. Overall 97 patients (81%) were not or little disabled in their daily activity. One hundred and twelve patients (93%) were free or considerably less symptomatic. Seventy-eight patients or 65% reported to be very satisfied with their current quality of life and 112 patients (93%) felt very reassured to have continuous full access to medical treatment despite of their advanced age.
  
  
  CONCLUSIONS
  A remarkable quality of life and important improvement in the functional status after cardiac surgery in patients over 80 paired with a satisfactory medium-term survival justify early intervention for heart disease in this age group. Therefore, referral practice for patients over 80 years for heart surgery should be handled liberally.
authors: Division of Cardiovascular Surgery, University Hospital of Lausanne, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. Christoph.Huber@hospvd.ch
authors: Christoph H
authors: CH
authors: Huber
authors: Volkhard
authors: V
authors: Goeber
authors: Pascal
authors: P
authors: Berdat
authors: Thierry
authors: T
authors: Carrel
authors: Friedrich
authors: F
authors: Eckstein
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality / Q000523:psychology; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality / Q000523:psychology; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality / Q000523:psychology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D011184:Postoperative Period; D011788:Quality of Life; D016896:Treatment Outcome