OBJECTIVE: We studied disease and surgical outcomes in an 80-plus age group to determine the feasibility of cardiac surgery at this age. METHODS: Between January 1991 and August 2000, we statistically analyzed 19 variables in 62 consecutive cases of cardiac surgery in the 80-plus age group to predict in-hospital and long-term mortality. Cases were classified by disease type (ischemic heart disease (IHD), n = 39; valvular heart disease (VHD) n = 19; and mechanical complications associated with acute myocardial infarction, n = 4; and by surgical status (emergency, n = 6; urgent, n = 10; and elective, n = 46). We compared these with 370 patients 70 to 79 years undergoing similar procedures during the same interval. RESULTS: No significant difference was seen between groups in total in-hospital mortality--9.7% vs. 3.8%--or in-hospital mortality for IHD--2.6% vs. 4.2%--or VHD--10.5% vs. 2.8%. We found cardiopulmonary bypass time > 150 min. and dialysis to be independent risk factors for hospital death. Actuarial survival at 7.5 years overall was 39% in the 80-plus age group vs. 53% in the 70-79 age group for VHD and 38% in the 80-plus age group vs. 62% in the 70-79 age group. No significant difference was seen in survival between groups for IHD. Stroke proved to be an independent prognostic factor. CONCLUSIONS: Cardiac surgery is conducted feasibly in selected octogenarians, providing acceptable mortality and results similar to those achieved in those 70 to 79 years old.
OBJECTIVE: We studied disease and surgical outcomes in an 80-plus age group to determine the feasibility of cardiac surgery at this age. METHODS: Between January 1991 and August 2000, we statistically analyzed 19 variables in 62 consecutive cases of cardiac surgery in the 80-plus age group to predict in-hospital and long-term mortality. Cases were classified by disease type (ischemic heart disease (IHD), n = 39; valvular heart disease (VHD) n = 19; and mechanical complications associated with acute myocardial infarction, n = 4; and by surgical status (emergency, n = 6; urgent, n = 10; and elective, n = 46). We compared these with 370 patients 70 to 79 years undergoing similar procedures during the same interval. RESULTS: No significant difference was seen between groups in total in-hospital mortality--9.7% vs. 3.8%--or in-hospital mortality for IHD--2.6% vs. 4.2%--or VHD--10.5% vs. 2.8%. We found cardiopulmonary bypass time > 150 min. and dialysis to be independent risk factors for hospital death. Actuarial survival at 7.5 years overall was 39% in the 80-plus age group vs. 53% in the 70-79 age group for VHD and 38% in the 80-plus age group vs. 62% in the 70-79 age group. No significant difference was seen in survival between groups for IHD. Stroke proved to be an independent prognostic factor. CONCLUSIONS: Cardiac surgery is conducted feasibly in selected octogenarians, providing acceptable mortality and results similar to those achieved in those 70 to 79 years old.
Authors: C W Akins; W M Daggett; G J Vlahakes; A D Hilgenberg; D F Torchiana; J C Madsen; M J Buckley Journal: Ann Thorac Surg Date: 1997-09 Impact factor: 4.330
Authors: K S Naunheim; M J Kern; L R McBride; D G Pennington; H B Barner; K R Kanter; A C Fiore; V L Willman; G C Kaiser Journal: Am J Cardiol Date: 1987-04-01 Impact factor: 2.778
Authors: E D Peterson; P A Cowper; J G Jollis; J D Bebchuk; E R DeLong; L H Muhlbaier; D B Mark; D B Pryor Journal: Circulation Date: 1995-11-01 Impact factor: 29.690
Authors: M Kirsch; L Guesnier; P LeBesnerais; M L Hillion; M Debauchez; J Seguin; D Y Loisance Journal: Ann Thorac Surg Date: 1998-07 Impact factor: 4.330