Cardiac surgery for octogenarians--a suitable procedure? Twelve-year operative and post-hospital mortality in 641 patients over 80 years of age

The Thoracic and Cardiovascular Surgeon
F W SchmidtlerB Gansera

Abstract

The increase in life expectancy as a result of therapeutic improvements subsequently leads to a large number of patients with advanced age. The aim of this study was to review the 30-day mortality and mid-term outcome of octogenarians undergoing coronary artery bypass grafting (CABG) or valve replacement (AVR/MVR). The data of 641 patients with a mean age of 82.6 years (range 80.0 - 92.6), operated between 9/93 and 12/05, were reviewed. 432 patients underwent CABG, 188 had AVR and 21 had MVR. We analysed peri-/postoperative mortality and clinical outcomes. Follow-up was obtained by phone contact with patients or their physician. Mid-term survival was determined for the whole population by the Kaplan-Meier method; peri- and postoperative risk factor analysis was done using logistic regression. Follow-up ranged from 0.1 to 11.8 years (mean 3.6 +/- 2.6) and was complete for 99%. We observed a perioperative mortality of 8.8% for CABG, 4.8% for AVR and 9.5% for MVR. Perioperative mortality was strongly associated with urgent/emergent operations (P < 0.03), poorer clinical status (P < 0.03), renal dysfunction (P < 0.05) and male gender (P < 0.04). Actuarial survival after 3, 5 and 8 years was as follows: CABG 78%, 66% and 44%; AVR 79...Continue Reading

Citations

Aug 28, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bedriye SenAndreas Böning
Feb 6, 2010·The Journal of Cardiovascular Nursing·Laura Beth Nugteren, Kristin E Sandau
Sep 17, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Ali AndalibNicolo Piazza
Dec 2, 2015·Interactive Cardiovascular and Thoracic Surgery·Jan-Philipp MinolArtur Lichtenberg
Mar 20, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Fausto BiancariGiulia Vinco
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Jul 23, 2009·Deutsches Ärzteblatt International·Ivar FriedrichRolf-Edgar Silber
Sep 24, 2009·Circulation·Donald S LikoskyUNKNOWN Northern New England Cardiovascular Disease Study Group

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