Cardiac reoperation in patients aged 80 years and older.
BACKGROUND
The benefit of cardiac surgery in octogenarians is well described. Today, nearly every second patient who undergoes cardiac surgery is older than 70 years. The time between primary cardiac surgery and reoperation is 7 to 13 years. Therefore, in the future we can expect to see an increasing number of reoperations in octogenarians.


METHODS
We studied 71 patients (41 male) with a mean age of 83 +/- 2.8 years, who underwent cardiac reoperation between 1994 and 2006. These patients were compared with 71 octogenarians who underwent primary cardiac operation. Patients were matched for age, sex, year of operation, and surgical procedure. Demographic profiles, operative data, long-term survival, and quality of life by the Short-Form 36-Item Health Survey questionnaire were analyzed.


RESULTS
Average time between previous operation and reoperation was 10.8 +/- 5.6 years (range: 1.7 to 30.6). The 30-day mortality rate was 14.7% in the reoperation group and 8.5% (p = 0.43) in the control group. Actuarial survival at 1, 3, and 6 years was 71% +/- 5.5%, 60.5% +/- 6.1%, and 30% +/- 8.1% for patients who underwent cardiac reoperation; and 77.2% +/- 5%, 58.3% +/- 6.3%, and 36.3% +/- 7.8% for matched octogenarians who underwent primary cardiac surgery (p = 0.68). No significant differences were found between groups regarding the physical health summarized score (40.7 +/- 9.4 versus 39.1 +/- 10; p = 0.55) and the mental health summarized score (51.9 +/- 10.9 versus 48 +/- 12.9; p = 0.24) of the Short-Form 36-Item Health Survey questionnaire.


CONCLUSIONS
Octogenarians exhibit a similar long-term survival and quality of life after primary and redo cardiac surgery. Therefore, cardiac reoperation should not be a contraindication per se in octogenarians.
Krane
Markus
M
Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany. krane@dhm.mhn.de
Bauernschmitt
Robert
R
Hiebinger
Andreas
A
Wottke
Michael
M
Voss
Bernhard
B
Badiu
Catalin Constantin
CC
Lange
Rüdiger
R
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000401:mortality / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors