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[Cardiac surgery in octogenarians]

R Stevens1, P Gersbach, P Ruchat

  • 1Service de chirurgie cardiovasculaire, CHUV, Lausanne.

Schweizerische Medizinische Wochenschrift
|October 28, 1995
PubMed
Summary
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Cardiac surgery in patients over 80 is feasible, with outcomes comparable to younger groups when myocardial reserve is adequate. This procedure significantly improves functional status in elderly patients.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Cardiac Surgery

Background:

  • Cardiac surgery is typically performed on younger patients.
  • Elderly patients (80+) present unique challenges for cardiac surgery due to comorbidities and reduced physiological reserve.

Purpose of the Study:

  • To evaluate the safety and efficacy of cardiac surgery in octogenarian patients.
  • To compare outcomes in octogenarians with a younger control group.

Main Methods:

  • Retrospective analysis of 37 patients aged 80+ undergoing cardiac surgery over 11 years.
  • Comparison with a matched control group of patients aged 60-69.
  • Assessment of operative indications, procedures, mortality, complications, hospital stay, and long-term survival.

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Main Results:

  • 5.4% 30-day mortality and 57% 5-year survival in octogenarians.
  • Comparable survival rates to younger controls, with higher rates of conduction disturbances and delirium.
  • Significant improvement in functional status post-surgery (84% to 24% severely symptomatic).

Conclusions:

  • Cardiac surgery is a viable option for octogenarians with sufficient myocardial reserve.
  • Outcomes in octogenarians are comparable to younger groups regarding perioperative mortality.
  • Surgery offers substantial functional improvement for elderly patients requiring cardiac procedures.