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Related Experiment Videos

Cardiac surgery in the octogenarian.

T P Tsai, J M Matloff, R J Gray

    The Journal of Thoracic and Cardiovascular Surgery
    |June 1, 1986
    PubMed
    Summary

    Cardiac surgery in octogenarians (80-89 years) shows significant early mortality (13%) and complications. However, survivors experience functional improvement, supporting timely surgical intervention for selected patients.

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    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Geriatric Medicine

    Background:

    • Octogenarians (aged 80-89) represent a growing population undergoing cardiac operations.
    • Preoperative functional status, particularly New York Heart Association (NYHA) Class IV, is a critical factor in outcomes.
    • The safety and efficacy of cardiopulmonary bypass in this age group require careful evaluation.

    Purpose of the Study:

    • To evaluate the early and late outcomes of cardiac operations in octogenarians.
    • To identify risk factors associated with mortality and morbidity in this patient cohort.
    • To assess the functional status improvement in survivors post-cardiac surgery.

    Main Methods:

    • Retrospective analysis of 76 consecutive octogenarian patients undergoing cardiac operations.

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  • Procedures included coronary artery bypass grafting (CABG), valve replacement, and combined procedures.
  • Data collected on early mortality, postoperative complications, hospital stay, and late cardiac-related deaths.

    • Main Results:

    • Overall early mortality was 13% (10 deaths), with higher rates in combined procedures (30%).
    • Major postoperative complications occurred in 29.1% of survivors.
    • Risk factors for mortality included NYHA Class IV status, combined procedures, intra-aortic balloon pump use, and reoperation for bleeding.

    Conclusions:

    • Cardiac surgery in octogenarians can be performed with acceptable outcomes, particularly for isolated coronary artery disease and valve disease.
    • Timely surgical intervention is recommended to prevent progression to higher-risk NYHA Class IV status.
    • Survivors demonstrate significant functional class improvement, supporting the benefits of surgery in carefully selected elderly patients.