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Cardiac reoperations in octogenerians
P Ghosh1, D Holthouse, I Carroll
1The Cardiothoracic Surgical Unit, Royal Perth Hospital, Australia. probalg@hotmail.com
Summary
Cardiac reoperations in octogenarians can yield satisfactory outcomes, but require careful patient selection due to increased risks and longer recovery. This study analyzed outcomes for this elderly subset undergoing reoperation.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
Background:
- Increasing numbers of elderly patients are undergoing cardiac surgery.
- Advances in primary cardiac operations have led to higher expectations for reoperation in octogenarians.
Purpose of the Study:
- To analyze the outcomes of cardiac reoperations in octogenarians.
- To evaluate the safety and efficacy of reoperative cardiac surgery in this specific elderly demographic.
Main Methods:
- Retrospective review of 18 octogenarians (mean age 81.2 years) who underwent cardiac reoperations between November 1989 and August 1998.
- Analysis included patient demographics, preoperative status (NYHA class, Parsonnet score), surgical procedures (AVR, MVR, CABG), and postoperative outcomes.
Main Results:
- The study included 18 octogenarians, representing 6.2% of octogenarian cardiac surgical patients and 2.7% of all reoperations.
- Hospital mortality was 5.5% (1 death), with three late deaths (17.6%) occurring during follow-up.
- Long-term survivors showed improved functional status (mean NYHA 1.9) and lifestyle, with 90% of men and 50% of women surviving at a mean follow-up of 42.7 months.
Conclusions:
- Cardiac reoperations in highly selected octogenarians can achieve satisfactory outcomes.
- Increased procedural risks, longer hospital stays, and slower convalescence should be anticipated.
- Careful patient screening and reconsideration of primary operation strategies for elderly patients are warranted.