Related Experiment Videos
[Cardiovascular interventions in elderly patients]
M Pasic1, L von Segesser, T Carrel
1Departement Chirurgie, Universitätsspital Zürich.
Insights
Heart surgery in patients aged 70-81 shows acceptable risks and satisfactory long-term outcomes. Elderly patients undergoing cardiac procedures experienced significant functional status improvement post-surgery.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Outcomes Research
Context:
- The number of elderly patients undergoing cardiac surgery has increased significantly.
- Older adults present unique challenges and risks for major surgical procedures.
Purpose:
- To evaluate the outcomes of aortocoronary bypass surgery and valvular surgery in patients aged 70 years and older.
- To assess the operative mortality, survival rates, and functional status improvement in this elderly cohort.
Summary:
- A study of 204 patients (70-81 years) undergoing bypass surgery and 20 patients (≥80 years) undergoing valve surgery from 1981-1990.
- Bypass surgery had a 6.8% operative mortality and 5-year survival of 86%. Valvular surgery had a 15% operative mortality and 5-year survival of 67%.
- Most patients improved from NYHA functional class III/IV to I/II postoperatively, indicating satisfactory long-term results.
Impact:
- Cardiac surgery in the elderly is associated with increased but acceptable operative risks.
- The findings support the feasibility and benefit of cardiac operations in older adults, with significant functional gains.
- This research highlights the importance of considering surgical interventions for elderly patients with severe cardiac conditions.
Abstract:
From January 1981 to December 1990, 204 patients between 70 and 81 years of age underwent aortocoronary bypass-surgery, and 20 patients age 80 years or older underwent valvular surgery. The operative mortality rate (30-day mortality) of aortocoronary bypass-surgery was 6.8%; actuarial survival rate at 1 and 5 years was 92% and 86%, respectively. The operative mortality rate of valvular surgery was 15%; actuarial survival rate at 1 and 5 years was 78.5% and 67%, respectively. The mean follow-up was 25 months. Most patients undergoing myocardial revascularization (71%) and all the patients undergoing valvular surgery were preoperatively in New York Heart Association (NYHA) functional class III or IV, at the end of the follow-up in NYHA functional class I or II (95%). A rapid rise in the number of heart operations in the elderly is evident. It is associated with increased but acceptable operative risk. Longterm results and postoperative improvement of functional status are satisfactory.