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Re-do cardiac surgery in patients over 70 years old
W I Awad1, A C De Souza, P G Magee
1Department of Cardiothoracic Surgery, The London Chest Hospital, UK.
Summary
Cardiac re-operations in patients over 70 have acceptable risks and good functional outcomes. This study analyzed outcomes for elderly patients undergoing repeat cardiac surgery, finding a 7% operative mortality and significant functional improvement post-procedure.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Cardiac Re-operations
Background:
- Cardiac re-operations are increasingly common in elderly populations.
- Assessing the safety and efficacy of repeat cardiac surgery in patients over 70 is crucial.
Purpose of the Study:
- To determine the outcomes of cardiac re-operations in patients aged 70 years and older.
- To evaluate the operative morbidity, mortality, and functional status following repeat cardiac procedures in this demographic.
Main Methods:
- Retrospective review of case notes for patients over 70 who underwent 're-do' cardiac surgery between January 1987 and October 1995.
- Telephone follow-up was conducted to assess medium-term functional status.
Main Results:
- 110 patients (16%) over 70 underwent re-do cardiac surgery, with Coronary Artery Bypass Grafting (CABG) and Mitral Valve Replacement (MVR) being the most common procedures.
- The overall operative mortality was 7%. Major in-hospital complications included resternotomy (5%), stroke (3%), and renal failure (2%).
- At a median follow-up of 34 months, 90% of surviving patients were in NYHA functional class I/II.
Conclusions:
- Cardiac re-operations in patients over 70 demonstrate acceptable operative morbidity and mortality.
- Repeat cardiac surgery in this elderly cohort leads to good functional improvement at medium-term follow-up.