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OPEN HEART SURGERY IN THE ELDERLY
Author(s) -
Mullany CharlesJ.,
Clarebrough JohnK.,
White AntoineteL.,
Wilson AnthonyC.
Publication year - 1987
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1987.tb01252.x
Subject(s) - medicine , aortic valve replacement , artery , stenosis , bypass grafting , cardiology , mitral valve replacement , coronary artery disease , coronary artery bypass surgery , surgery , valve replacement , valvular heart disease , cardiac surgery , mitral valve
Of 3254 open heart surgical cases performed since 1972, 126 patients (3.9%) were 70 years of age or older. The mean age was 72 years, the oldest being 82. Sixty‐seven per cent were male. The following procedures were performed: coronary artery bypass grafting (cabg) 51, aortic valve replacement (avr) 44, avr + cabg 16. Mitral valve replacement (mvr) 3, mvr + cabg 6, mvr + avr 4, and other, 2. Of those undergoing cabg, 33% came from the coronary care unit and 24% bad left main coronary artery stenosis. There was one peri‐operative death (2.0%). Of those undergoing avr, 43% had coronary artery disease and 13% triple vessel disease. Operative mortality for avr, and avr + cabg was 11.4% (5/44) and 18.8% (3/16). Respectively. Twenty‐six per cent of operative survivors bad significant postoperative complications (excluding atrial arrhythmias). The postoperative hospital stay for cabg, avr and other cases was 11, 13 and 16 days, respectively. Seven year survival of all patients was 61.2 ± 6.5% (±1 se) and for avr + cabg was 51.5 ± 8.6%. Five year survival for cabg was 83.9 ± 6.3%. We conclude that, in selected cases, cabg can be performed safely in the elderly. Although valvular and combined surgery may result in significant morbidity and mortality, the satisfactory long term results in survivors justifies surgery in this group of patients.