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[The short- and long-term results in heart surgery of the elderly]
Insights
Cardiac surgery in elderly patients significantly improves symptoms and quality of life, offering excellent survival rates despite increased operative risks. This study highlights the benefits of cardiac procedures for older individuals.
Area of Science:
- Cardiology
- Geriatric Medicine
- Surgical Outcomes
Context:
- Retrospective study of 106 elderly patients (≥69 years) undergoing cardiac surgery between 1986-1989.
- Analysis included coronary artery bypass grafting, valve replacement, and complex aortic/ventricular procedures.
- Predominantly elective surgeries (91%) with a mean postoperative hospital stay of 12 days.
Purpose:
- To evaluate the safety and efficacy of cardiac surgery in an elderly population.
- To assess symptom relief, quality of life, and survival post-cardiac surgery in older adults.
- To determine the overall impact of surgical intervention on geriatric cardiac patients.
Summary:
- Hospital mortality was 5% (6 patients).
- Mean follow-up was 37 months, with 16 deaths (5 non-cardiac).
- 96% of survivors reported significant improvement in symptom status and quality of life.
Impact:
- Cardiac surgery in the elderly, while carrying higher risks, provides substantial symptomatic relief and good long-term survival.
- Demonstrates the value of surgical intervention for improving quality of life in older patients with cardiac conditions.
- Supports the consideration of cardiac surgery for carefully selected elderly patients.
Abstract:
We have studied retrospectively 106 patients aged 69 years or older (range 69 to 79) who underwent cardiac surgery between November 1986 and December 1989. The majority of patients (61%) were male. Coronary artery bypass surgery was performed in 59 patients, isolated valve replacement in 38 and combined valve replacement with coronary artery bypass surgery in 5. Two patients underwent ascending aorta replacement for aortic dissection and 2 ventricular aneurysmectomy and postinfarction ventricular septal defect repair. The mean postoperative hospital stay was 12 days. Ninety-one percent of patients underwent a primary elective operation and 9% required an emergency operation. Hospital mortality was 5% (n = 6). All hospital survivors were followed up by telephone contact (mean follow-up: 37 months) to determine presence or absence of chest pain, dyspnea, postoperative NYHA class and the overall effect of surgery on quality of life. There were 16 follow-up deaths; 5 were non cardiac. Follow-up study showed significant improvement in symptom status and quality of life (96%). We concluded that cardiac surgery in the elderly, although associated with increased operative risk, gives excellent relief of symptoms and good survival.