title: Cardiac surgery in 260 octogenarians: a case series.
abstract: BACKGROUND
  The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period.
  
  
  METHODS
  A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period).
  
  
  RESULTS
  Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality.
  
  
  CONCLUSIONS
  Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Anna Mara
authors: AM
authors: Scandroglio
authors: Department of Medical Sciences "M. Aresu", Cagliari University, Cagliari, Italy.
authors: Gabriele
authors: G
authors: Finco
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Marina
authors: M
authors: Pieri
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Roberto
authors: R
authors: Ascari
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Maria Grazia
authors: MG
authors: Calabrò
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Daiana
authors: D
authors: Taddeo
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Francesca
authors: F
authors: Isella
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
authors: Annalisa
authors: A
authors: Franco
authors: Department of Medical Sciences "M. Aresu", Cagliari University, Cagliari, Italy.
authors: Mario
authors: M
authors: Musu
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy ; Vita-Salute San Raffaele University, Milan, Italy.
authors: Giovanni
authors: G
authors: Landoni
authors: Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy ; Vita-Salute San Raffaele University, Milan, Italy.
authors: Ottavio
authors: O
authors: Alfieri
authors: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy ; Vita-Salute San Raffaele University, Milan, Italy.
authors: Alberto
authors: A
authors: Zangrillo
mesh_terms: D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Anesthesia; Cardiac surgery; Complications; Intensive care; Mortality; Octogenarian