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Cardiac surgery in the very elderly
V Z Shah1, F L Rosenfeldt, G W Parkin
1Saint Francis Xavier Cabrini Hospital, Malvern, Vic.
Insights
Cardiac surgery in very elderly patients shows a 7% in-hospital mortality rate and an 88% one-year survival. This intervention significantly improves functional status for those with severe cardiac symptoms.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
Background:
- The very elderly population (≥79 years) often presents with severe cardiac conditions.
- Limited data exists on the outcomes of open-heart surgery in this demographic.
Purpose of the Study:
- To evaluate the efficacy and safety of cardiac surgery in very elderly patients.
- To assess survival rates and functional outcomes post-intervention.
Main Methods:
- Retrospective analysis of 56 patients aged 79-89 years undergoing open-heart surgery.
- Procedures included coronary artery bypass grafting (33 patients) and valve replacement (23 patients).
- Data collected from 1988-1991 at a large private hospital.
Main Results:
- In-hospital mortality was 7% (4 deaths).
- One-year actuarial survival rate was 88%.
- Significant functional improvement observed: 92% of survivors improved from NYHA Class III/IV to Class I/II post-surgery.
Conclusions:
- Cardiac surgery is a viable option for very elderly patients with medically refractory symptoms.
- The procedure offers a tolerable mortality risk and excellent symptom relief.
- Improved functional capacity post-surgery is a key benefit for this age group.
Objective:
To determine the results of cardiac surgery in the very elderly.
Design And Subjects:
A retrospective study of 56 very elderly patients (mean age 82 years, range 79-89 years) undergoing open heart surgery between 1988 and 1991. Thirty-three patients had coronary artery bypass grafting, 12 had valve replacement alone and 11 had valve replacement with an associated procedure.
Setting:
St Francis Xavier Cabrini Hospital, Melbourne--a large private hospital.
Results:
There were four in-hospital deaths (7%). The one-year actuarial survival rate was 88%. Of the 49 survivors, 92% were in New York Heart Association (NYHA) Class III or IV before operation, whereas 96% were in NYHA Class I or II a mean of 15 months after operation.
Conclusion:
In very elderly patients with medically refractory cardiac symptoms, cardiac surgery has a tolerable mortality and provides excellent relief of symptoms.