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Cardiac anesthesia and surgery in geriatric patients
George Silvay1, Javier G Castillo, Joanna Chikwe
1Department of Anesthesiology, Mount Sinai Medical Center, New York, NY 10029-6574, USA. george.silvay@msnyuhealth.org
Seminars in Cardiothoracic and Vascular Anesthesia
|April 10, 2008
Summary
Elderly patients over 80 can safely undergo cardiac surgery. Careful preoperative assessment and optimized anesthetic management lead to excellent outcomes in this growing population.
Area of Science:
- Cardiology
- Geriatric Medicine
- Anesthesiology
Background:
- The US population is aging, with over 15 million individuals aged 80+.
- Coronary artery disease and degenerative cardiovascular diseases are common in the elderly.
- Increased referrals for surgical intervention in this demographic necessitate specialized care.
Purpose of the Study:
- To review age-related physiological changes impacting cardiac anesthesia.
- To discuss perioperative and intraoperative management considerations for elderly patients.
- To evaluate early and late operative outcomes in octogenarians undergoing cardiac surgery.
Main Methods:
- Review of age-related changes in organ subsystems relevant to cardiac anesthesia.
- Analysis of perioperative issues and intraoperative management strategies.
- Examination of operative outcomes in octogenarians.
Main Results:
- Advanced age presents decreased physiologic reserve and increased comorbidity.
- Age-related changes affect anesthetic management, monitoring, and postoperative care.
- Selected elderly patients can achieve excellent outcomes from cardiac surgery.
Conclusions:
- No patient is "too old" for cardiac surgery.
- Thorough preoperative assessment and risk factor identification are critical.
- Optimized anesthetic and perioperative care improve outcomes for octogenarian cardiac surgery patients.
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