Short Term Results of Cardiac Surgery in Patients Over 80 Years of Age
Kemal Uzun, Turan Erdoğan
Keywords: Cardiac Surgery, Older Than Eighty Years.
Background: Despite relatively higher risk of cardiac operation over 80 years of age, the rate of cardiac operations in this age group is rising gradually. We aimed in our study to draw attention to the increased frequency of this age group patients and retrospectively to investigate postoperative short term results in our patients. Patients and Method: In this study 58 patients (31 males, 27 females; mean age 83.74±2.769; range 80 to 89 years) who underwent cardiac surgery in our clinic between June 2008 and July 2010 were reviewed. Fifty two patients (89.7%) underwent coronary artery by-pass grafting (CABG) (5 of them off-pump), one patient (1.7%) underwent CABG + aortic valve replacement (AVR), one patient (1.7%) underwent CABG + mitral valve replacement (MVR), one patient (1.7%) underwent CABG + left ventricle aneurysmectomy, one patient (1.7%) underwent AVR + MVR, and two patients (3.4%) underwent CABG + AVR + MVR. We used biological valves in all patients requiring valve replacement. Left internal mammary artery was used in 49 (90.74%) of 54 patients in whom left anterior descending artery was diseased. The number of distal anastomosis was 3.14±1.00 in average. Results: Hospital mortality was 1.7% with one case. This patient who had preoperative renal function disorder lost his life due to multiorgan failure which was induced by renal failure. 0ne patient was reopened because of postoperative bleeding (1.7%). Twelve patients developed temporary atrial fibrillation (20.7%). Permanent pace-maker implantation was not required for any patient. Three patients (5.2%) suffered for wound infections at saphenous vein region. No sternal infection or mediastinitis was encountered. No patient experienced minor or major neurologic event. While two patients (3.4%) remained intubated for more than 24 hours, 6 patients (10.3%) stayed in intensive care unit for more than 2 days. Conclusion: When rational decisions are made in the selection of patients and surgical procedures, cardiac surgery can be done with low mortality and morbidity rates in octogenarian patients