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Incidence of cardiac surgery in octogenarian patients: retrospective study
Luciano Brandão Machado1, Sílvia Chiaroni, Paulo Oliveira Vasconcelos Filho
1CET/SBA do Hospital das Clínicas da Universidade de São Paulo (HC-FMUSP), São Paulo, SP.
Background And Objectives:
Increased life expectancy makes increasingly older patients to be submitted to cardiac surgeries. This study aimed at evaluating the incidence of octogenarian patients submitted to cardiac surgeries in the Heart Institute, Hospital das Clínicas, FMUSP, in the last 16 years.
Methods:
The number of myocardial revascularization (MR) and valvar surgeries (VS) was analyzed for the period 1986 to 2001 and, within each group, the number of surgeries in octogenarian patients. Data were descriptively analyzed.
Results:
Data have shown a progressive increase in the number of octogenarian patients submitted to cardiac surgeries. Myocardial revascularization surgeries have increased from 0.13% in 1986 to 3.5% in 2001. Valvar surgeries have increased from 0% in 1986 to 1.44% in 2001, with the highest rate of 3.02% in 1999.
Conclusions:
The understanding of pathophysiology and senility, and the advances in surgical trauma handling are allowing cardiac surgery resources to be expanded to elderly patients. Anesthetic technique should be carefully chosen, as well as hydration, ventilatory assistance and postoperative analgesia, to provide decreased morbidity and mortality in this higher surgical risk group.
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