Cardiac surgery in octogenarians

Ishikawa, Susumu; Buxton, Brian F.; Manson, Narelle; Hadj, Anthony; Seevanayagam, Siven; Raman, Jai; Rosalion, Alexander; Morishita, Yasuo

doi:10.1111/j.1445-1433.2004.03214.x

Cited by 27 publications

(12 citation statements)

References 9 publications

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“…On the other hand, CABG was associated with favorable outcomes after the perioperative period; this finding was consistent with the results of previous studies showing that octogenarians who survived to CABG have a midterm and long-term survival similar to that of the general population of octogenarians. 23,24 The present study found the EuroSCORE to be the most powerful predictor of MACCE at midterm follow-up after LMCA revascularization in octogenarian patients regardless of revascularization modality. This suggests that, in this very old and high-risk population, an estimation of the global patient risk with the EuroSCORE might be superior for the prediction of cardiovascular events to procedural and anatomic factors that have previously been recognized as prognostic factors in the setting of LMCA revascularization.…”

Section: Discussionmentioning

confidence: 50%

Nonrandomized Comparison of Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention for the Treatment of Unprotected Left Main Coronary Artery Disease in Octogenarians

et al. 2008

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In this single-center, nonrandomized study, there were no significant differences in cardiac death or myocardial infarction and MACCE between CABG and PCI for the treatment of left main coronary artery disease in octogenarians after a mean follow-up of 2 years. Baseline EuroSCORE was the most important predictor of MACCE regardless of the type of revascularization. Randomized studies comparing both revascularization strategies in this high-risk coronary population are warranted.

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Section: Discussionmentioning

confidence: 50%

Nonrandomized Comparison of Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention for the Treatment of Unprotected Left Main Coronary Artery Disease in Octogenarians

et al. 2008

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“…31 More recently, octogenarians (mean age 82 years) who underwent isolated elective CABG were found to have a satisfactory risk-benefit profile in the long term. 32 The mortality was 7% and the 5-year actuarial survival rate for the hospital survivors was 75% in this study, with a mean survival period of 76 months. However, for urgent or emergent cases, a marked increase in morbidity and mortality was noted.…”

Section: Survival Benefitsmentioning

confidence: 47%

“…However, for urgent or emergent cases, a marked increase in morbidity and mortality was noted. 32 Indeed, the data in many of the above studies are several years old, but with technical and procedural advancement, we can only expect the outcomes to get better. This is in fact corroborated by recently published data from a prospective study in a UK tertiary centre, which shows excellent long-term survival rates after CABG for individuals aged .80 years.…”

Section: Survival Benefitsmentioning

confidence: 99%

Coronary artery bypass surgery in elderly people

Natarajan

Samadian²,

Clark³

2007

Postgraduate Medical Journal

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An increasing number of elderly individuals are now undergoing coronary artery bypass surgery. Elderly patients, compared with patients of a younger age group, present for surgery with a greater burden of risk factors and reduced functional levels. Short-term outcomes are hence poorer in them. But symptom relief occurs in most survivors and is accompanied by excellent rates of long-term survival and a good quality of life. Therefore, an individualised risk-benefit profile must be carefully constructed by clinicians, taking into account several different factors and not just age alone. This review summarises the current concepts of coronary artery bypass surgery from the perspective of the very old.

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“…It is well known that urgent operative procedures result in an overall higher risk of morbidity and mortality in octogenarians (3, 12, 13). Ishikawa et al reported a 4-fold increase in operative mortality in the urgent or emergency operation group compared to the elective cases (10). In our study, there was no operative mortality for the 15 elective operation cases, and one operative death was observed in the 5 urgent cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Cardiac Surgery in Octogenarians

Park

Lee

et al. 2005

J Korean Med Sci

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The purpose of this study was to investigate the operative results and the clinical outcomes for octogenarians who underwent cardiac surgery. Twenty consecutive octogenarians who had cardiac operations at Samsung Medical Center from October 1994 through December 2004 were included in the study. The medical records were retrospectively reviewed and the follow-up results were obtained by the interview. The patients were 15 men and 5 women, and their mean age was 83.1 yr (range: 80-89 yr). The surgical priority was urgent for 5 patients and it was elective for 15 patients. Coronary artery bypass grafting (CABG) was performed in 14 patients, valve surgery was performed in 4 patients and CABG plus valve surgery was performed in 2 patients. There was one hospital death on day one after urgent CABG in an 80-yr-old man who had left main coronary artery occlusion. There were three deaths during the follow-up. Sudden death occurred in one patient at 2 months after valve surgery, and there were two non-cardiac deaths at 12 and 14 months, respectively, after CABG. Non-fatal postoperative complications occurred in 2 of 5 urgent patients and in 3 of 15 electives. The survival rate for the 19 hospital survivors at 24 months after surgery was 80% and the mean follow-up period was 22.5 months (range: 1-58 months). In conclusion, cardiac surgery could be performed within acceptable limits of the risk and its long-term results could be expected to be favorable for the octogenarians.

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Cardiac surgery in octogenarians

Abstract: Early and late results for elective surgery in octogenarians are satisfactory. However, for urgent or emergent cases, there is a marked increase in morbidity and mortality.

Cited by 27 publications

References 9 publications

Nonrandomized Comparison of Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention for the Treatment of Unprotected Left Main Coronary Artery Disease in Octogenarians

Nonrandomized Comparison of Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention for the Treatment of Unprotected Left Main Coronary Artery Disease in Octogenarians

Coronary artery bypass surgery in elderly people

Clinical Outcome of Cardiac Surgery in Octogenarians

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