[Cardiac surgery in octogenarians: a five-year experience].

Nicola Pederzolli, Vinicio Fiorani, Anna Maizza, Ernesto Tappainer, Mario Zogno
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Abstract

Background: Cardiac surgery in octogenarians is increasing in industrialized countries and therefore represents a growing population. The aim of this study was to evaluate characteristics and outcomes of octogenarian patients undergoing cardiac surgery.

Methods: We reviewed all consecutive octogenarians operated on during the last 5 years. Among 1912 patients operated on between April 2000 and December 2004, we identified 223 patients (11.6%) aged > 80 years. Median age was 82.17 +/- 2.11 years, and 52.5% were males. The mean EuroSCORE score was 9.4 +/- 1.8. Among them 43 patients (19.3%) had isolated aortic valve replacement, 127 patients (57%) had isolated coronary artery bypass graft, 40 patients (17.9%) had aortic valve replacement combined with coronary artery bypass graft, 11 patients (4.9%) had mitral valve repair, and 2 patients (0.9%) had ventricular septal rupture repair.

Results: The overall hospital mortality was 5.4%; cumulative actuarial survival at 4 years was 77.6%.

Conclusions: We conclude that for unselected octogenarians the operative mortality is acceptable and only slightly increased than in younger age groups; the late survival rate is good.

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[八十多岁老人的心脏手术:五年经验]。
背景:在工业化国家,八十多岁老人的心脏手术正在增加,因此代表了一个不断增长的人口。本研究的目的是评估八十多岁接受心脏手术患者的特点和预后。方法:回顾性分析近5年来所有连续手术的80多岁老人。在2000年4月至2004年12月接受手术治疗的1912例患者中,年龄> 80岁的患者223例(11.6%)。中位年龄为82.17±2.11岁,男性占52.5%。平均EuroSCORE得分为9.4 +/- 1.8。其中孤立主动脉瓣置换术43例(19.3%),孤立冠状动脉旁路移植术127例(57%),主动脉瓣置换术联合冠状动脉旁路移植术40例(17.9%),二尖瓣修复术11例(4.9%),室间隔破裂修补术2例(0.9%)。结果:住院总死亡率为5.4%;4年累计精算生存率为77.6%。结论:我们得出的结论是,未选择的80多岁老人的手术死亡率是可以接受的,仅略高于年轻年龄组;晚期存活率很好。
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