Cardiac surgery in patients aged at least 80 years

Cardiac surgery in patients aged 80 years and over has become more acceptable with improvements in health care services and the steady increase in the number of octogenarians in the population. These demographic changes are reflected in an increasing number of octogenarians with advanced symptomatic disease undergoing complex cardiac intervention. We reviewed data from 62 articles on cardiac surgery in octogenarians. The medical and ethical issues involved in making the decision are complex. Long-term results of cardiac surgery in octogenarians show that these patients can withstand heart surgery with improved functional benefit and quality of life. Surgery is beneficial especially for patients undergoing coronary artery revascularization or isolated aortic valve surgery. The operative course in octogenarians is more complicated, which is reflected in longer postoperative hospitalization. In refutation of the assumption that mortality in octogenarians is related to multisystem failure, most deaths are cardiac in nature. Highly selective criteria (identifying risks and benefits individually) should be applied to octogenarians undergoing cardiac surgery to achieve a satisfactory result.