[Cardiac surgery in octogenarians]

An increasing number of patients above 80 years of age are referred for cardiac surgery, especially bypass surgery and aortic valve replacement. Because of high age these patients represent a special challenge. In this study we present our experience with cardiac surgery in patients aged 80 or older.

During an eight-year period, 213 patients at a mean age of 83.6 years (range 80-91 years) were referred for cardiac surgery. Acute operation within 24 hours of admission was performed in 5% of the patients. The cardiac procedures included coronary bypass surgery (60%), aortic valve replacement (20%), mitral valve surgery (3%), combined procedures (17%), and one patient with aortic dissection. All data were registered prospectively in a database and compared to a group of patients aged 60-79 years (n = 3312) who had been operated during the same period.

Mortality within 30 days was 8.5% for all patients, which was significantly higher compared with patients aged 60-79 years (2.9%) who had been operated in the same period. Survival after six months was 88%. Median length of stay in the intensive care unit was 1.9 days and the total postoperative length of stay was median 10.7 days versus 1.3 days and 8.7 days for patients aged 60-79 years. The octogenarians had significantly more atrial fibrillation and multiorgan failure compared to younger age groups.

This study shows that cardiac surgery can be performed in octogenarians with acceptable mortality and morbidity. A proper selection of patients for surgery based on risk evaluation is important.