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Published on: August 11, 2015
Cardiac operations in patients 80 years old and older
C W Akins1, W M Daggett, G J Vlahakes
1Cardiac Surgical Unit, Massachusetts General Hospital, Boston 02114, USA.
The Annals of Thoracic Surgery
|October 6, 1997
Summary
Cardiac operations in patients 80 years or older show increased hospital mortality and stroke, but long-term survival is good for many. Most patients found heart surgery after 80 to be a worthwhile choice.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Increasing numbers of elderly patients are undergoing cardiac surgery.
- This study reviews outcomes for patients aged 80 and older who had cardiac operations.
Purpose of the Study:
- To evaluate the success rates and outcomes of cardiac operations in octogenarian patients.
- To identify predictors of mortality, stroke, and prolonged hospital stay in this age group.
Main Methods:
- Retrospective review of 600 consecutive patients aged 80+ who underwent cardiac operations between 1985 and 1995.
- Follow-up data was 99% complete, assessing hospital mortality, stroke, prolonged stay, and long-term survival.
Main Results:
- Coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and combined AVR+CABG were common procedures.
- Hospital mortality rates ranged from 5.8% (CABG) to 18.0% (other operations), with stroke rates from 1.0% (AVR) to 10.8% (AVR+CABG).
- Five-year survival was 63% overall, influenced by factors like chronic lung disease, stroke, and heart failure.
Conclusions:
- Cardiac operations can be successful in octogenarians, despite higher risks of mortality, stroke, and extended hospital stays.
- Long-term survival is significantly impacted by co-existing medical conditions.
- The majority of patients (87%) considered undergoing cardiac surgery after age 80 a positive decision.
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