Short-term and long-term results of cardiac surgery in elderly and very elderly patients

The Journal of Thoracic and Cardiovascular Surgery
Giuseppe SpezialeLuigi Tavazzi

Abstract

Cardiac operations in elderly patients are increasingly frequent and imply major clinical, ethical, and economic issues. Operative and 5-year results of cardiac operations in patients aged 79 years or more are known in limited series, and a debate is ongoing on the appropriateness of selection of patients for surgery. We retrospectively reviewed our experience in 6802 patients aged 79 years or more who had received a cardiac operation. Surgical candidates were selected according to functional status, crude operative risk, and social context and were managed according to a multimodality protocol. Mean age was 82 years and surgery was nonelective in 1613 cases (23.5%, 31 salvage). Procedures consisted of valve replacement (aortic, 2817; mitral, 532; and tricuspid, 2 cases), valve repair (aortic, 66; mitral, 532; and tricuspid, 232 cases), coronary bypass grafting (12,034 coronary vessels bypassed), and replacement of the thoracic aorta (ascending, 315; arch, 28 cases). Overall operative mortality was 3.4%. Nonelective presentation, need for aortic counterpulsation, cardiopulmonary bypass time, blood transfusion, depressed systolic function, and chronic lung disease predicted operative mortality. Five-year cumulative mortality was...Continue Reading

References

May 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·A GehlotR C Daly
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Jan 31, 2007·Circulation·Colleen Gorman KochEugene H Blackstone
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Mar 22, 2008·The Annals of Thoracic Surgery·Donald S LikoskyUNKNOWN Northern New England Cardiovascular Disease Study Group
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Sep 23, 2008·The Journal of Thoracic and Cardiovascular Surgery·Colleen Gorman KochEugene H Blackstone

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Citations

Apr 2, 2015·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Neil Ruparelia, Bernard D Prendergast
Sep 29, 2015·Expert Review of Cardiovascular Therapy·Antonio MangieriAzeem Latib
Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·E St-LouisK Khwaja
Apr 10, 2013·The Annals of Thoracic Surgery·Manuel CaceresAlfredo Trento
Sep 11, 2012·The Annals of Thoracic Surgery·James J YunUNKNOWN Northern New England Cardiovascular Disease Study Group
Oct 24, 2012·ANZ Journal of Surgery·Ian HarrisShanley Chong
Jan 4, 2012·Journal of Cardiac Surgery·Sílvia Marta OliveiraPaulo Pinho
Jul 1, 2015·Heart·Neil Ruparelia, Bernard D Prendergast
Oct 3, 2015·Clinical Medicine : Journal of the Royal College of Physicians of London·Neil Ruparelia, Bernard D Prendergast

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