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Cardio-aortic operation in octogenarians.

M Ohashi1, S Fukunaga, H Kawano

  • 1Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume City, Fukuoka 830-0011, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 10, 2001
PubMed
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Cardio-aortic operations on octogenarians show high hospital mortality but acceptable mid-term survival. Early intervention is recommended for better outcomes in elderly patients.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Medicine
  • Thoracic Surgery

Background:

  • Japan's aging population and increased life expectancy necessitate evaluation of surgical outcomes in octogenarians.
  • Cardio-aortic operations are complex procedures with potentially high risks in elderly patients.

Purpose of the Study:

  • To review the outcomes of cardio-aortic operations performed on octogenarian patients.
  • To identify risk factors for mortality and assess long-term survival and quality of life in this demographic.

Main Methods:

  • A retrospective review of 33 consecutive octogenarian patients undergoing cardio-aortic operations between 1992 and 1998.
  • Data collected included patient demographics, preoperative New York Heart Association (NYHA) class, urgency of operation, procedures performed, and outcomes.

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Main Results:

  • Hospital mortality rate was 27%, with higher mortality in patients with NYHA class IV and urgent/emergency operations (89% of deaths).
  • Significant risk factors for hospital death included renal insufficiency, shock, NYHA class IV, intra-aortic balloon pumping, and prolonged cardiopulmonary bypass time.
  • One-, three-, and five-year survival rates were 73%, 68%, and 55%, respectively. 77% of survivors were in NYHA class I or II.

Conclusions:

  • Despite high hospital mortality, mid-term results for octogenarians undergoing cardio-aortic surgery are acceptable.
  • Survivors generally experience a satisfactory quality of life.
  • Operative intervention should be considered before patients reach a critically ill state, particularly in the octogenarian population.