Cardiac surgery in the very elderly

Abstract

ObjectiveTo determine the results of cardiac surgery in the very elderly. Design and subjectsA retrospective study of 56 very elderly patients (mean age 82 years, range 79‐89 years) undergoing open heart surgery between 1988 and 1991. Thirty‐three patients had coronary artery bypass grafting, 12 had valve replacement alone and 11 had valve replacement with an associated procedure. SettingSt Francis Xavier Cabrini Hospital, Melbourne — a large private hospital. ResultsThere were four in‐hospital deaths (7%). The one‐year actuarial survival rate was 88%. Of the 49 survivors, 92% were in New York Heart Association (NYHA) Class III or IV before operation, whereas 96% were in NYHA Class I or II a mean of 15 months after operation. ConclusionIn very elderly patients with medically refractory cardiac symptoms, cardiac surgery has a tolerable mortality and provides excellent relief of symptoms.

Cardiac surgery in Australian octogenarians: 1996−2001

“…>1000 cases per year). The only comparable Australian series, also from a medium caseload hospital, achieved a 7% operative (30 day) mortality 5 . The higher complication rate in that series (16−29%) may be reflective of an earlier era and/or sicker patients.…”

“…This is the first report specifically assessing the results of cardiac surgery in Australian octogenarians. Unlike previous series, we have collected data prospectively and have specifically talked to the patients to accurately assess their perspective on the benefits or otherwise of their surgery 5,6 .…”

“…Furthermore, we have prospectively assessed these patients following hospital discharge prospectively at 1 month, 1 year and with a final follow up in late 2001. Unlike many reported series we have specifically talked to the patients to accurately assess their perspective on the benefits or otherwise of their surgery 5,6 .…”

The Clinical Application of Metabolic Therapy for Cardiovascular Disease

“…However, in patients over 70 years of age the mortality is up to three times that in younger patients. 6 The incidence of postoperative complications such as renal failure, respiratory failure and arrhythmias is also higher than in younger patients. Mortality and complications are commonly related to low cardiac output.…”

Coenzyme Q10 improves the tolerance of the senescent myocardium to aerobic and ischemic stress: Studies in rats and in human atrial tissue

“…Over the last 20 years there has been a steady rise in the mean age of patients with ischemic heart disease presenting for interventional therapy [8]. However the early mortality for elderly patients after myocardial infarction [6], post-infarction reperfusion [24], angioplasty [13] and cardiac surgery [1,23] is up to three times greater than for younger patients, particularly in the urgent setting. Furthermore in recent years age has risen in significance as a predictor of mortality for coronary bypass surgery [5], and remains as one of the most significant predictors of failure after medical reperfusion [24].…”