Cirugía cardíaca en el anciano

Rodríguez, Rafael; Torrents, A; Garcia, P. Ancillo; Ribera, Aída; Permanyer, Gaietà; Moradi, Mejdad; Dousset, Pierre; Igual, A; Murtra, Marcos

doi:10.1016/s0300-8932(02)76779-1

Cited by 25 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the USA, about 82% of patients who die of CAD are aged 65 or older 1. On the other hand, despite recent advances,2–6 it is well known that both the morbidity and mortality of CAD patients subjected to invasive therapies (ITs – coronary artery bypass surgery or percutaneous coronary intervention) increase with age, and that pre-intervention MI is an independent risk factor for mortality 7. Despite certain data from clinical trials suggesting a greater benefit of IT in elderly patients with acute coronary syndromes,8;9 the applicability of findings from trials that enrolled predominantly younger patients to an older and generally less healthy population is questionable 10…”

Section: Introductionmentioning

confidence: 99%

The Role of Invasive Therapies in Elderly Patients with Acute Myocardial Infarction

Nicolau

Lemos

Wajngarten

et al. 2009

Clinics

View full text Add to dashboard Cite

INTRODUCTION:In elderly patients with acute myocardial infarction, very little is known about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive therapies - IT), especially in the context of long-term outcomes after hospital discharge.METHODS:We analyzed 1588 patients with MI who had been included prospectively in a databank and followed for up to 7.5 years. In this population, 548 patients were ≥70 years old (elderly group - EG), and 1040 were <70 years of age (younger group - YG); 1088 underwent IT during hospitalization, and the remaining 500 were treated medically (conservative therapy - CT). Patients were monitored either by visit or by phone at least once a year. A standard questionnaire was administered to all patients. The impact of IT was analyzed with both non-adjusted and adjusted models.RESULTS:By the end of the follow-up period, the survival rates for the IT and CT groups were, respectively, 71.9% versus 47.2% in the global population (hazard ratio=0.55, P<0.001), 81.5% versus 66.6% in the YG (hazard ratio=0.68, P=0.018) and 48.8% versus 20.3% in the EG (hazard ratio=0.58, P<0.001). In the adjusted models, the hazard ratios were 0.62 (P<0.001) in the global population, 0.74 in the YG (P=0.073) and 0.64 (P=0.001) in the EG.CONCLUSION:Long-term follow-up of patients with myocardial infarction revealed that IT during the in-hospital phase was at least as effective in elderly patients as in younger patients.

show abstract

Section: Introductionmentioning

confidence: 99%

The Role of Invasive Therapies in Elderly Patients with Acute Myocardial Infarction

Nicolau

Lemos

Wajngarten

et al. 2009

Clinics

View full text Add to dashboard Cite

show abstract

“…In comparison to younger patients, the mortality of elderly patients is higher. This results from deprived organ reserves and many concomitant disorders [ 5 – 7 ]. Perioperative mortality in our trial group was 4.2%.…”

Section: Discussionmentioning

confidence: 99%

“…We have adopted a strategy to operate on elderly CABG patients without the use of ECC (OPCAB). This modification is less invasive than the traditional approach, but still achieves a desirable effect [ 7 , 8 , 13 ]. About 75% of patients in this study were treated without ECC.…”

Section: Discussionmentioning

confidence: 99%

“…The most common complications included atrial fibrillation, renal failure, psychosis, and respiratory failure. Hence the need for longer hospitalization and more intensive or additional therapy, such as prolonged mechanical ventilation (over 12 hours), dialysis (CVVH), IABP, transfusions, and prolonged rehabilitation, which adds to the cost and delays recovery [ 5 – 7 , 11 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

CARDIAC SURGERY Early and long-term results of cardiosurgical treatment of coronary artery disease and aortic stenosis in patients over 80 years old

Budniak¹,

Buczkowski²,

Perek³

et al. 2014

kitp

View full text Add to dashboard Cite

BackgroundIn recent years, patients over 80 years of age have been a growing group of individuals referred to cardiac surgeons. They pose a serious challenge and usually require a multidisciplinary approach.AimThe aim of this study was to evaluate the early and late outcomes of cardiosurgical treatment of patients over 80 years of age suffering from coronary artery disease and aortic stenosis.Material and methodsThe study involved 96 patients aged over 80 years treated between January, 2004 and December, 2012. The mortality and morbidity in the early postoperative period, as well as throughout the follow-up period, were analyzed.ResultsThe majority of patients underwent isolated coronary artery bypass grafting (CABG) (58.3%; Group I), while 29.2% of them underwent an isolated aortic valve replacement (AVR) (Group II). Combined procedures (CABG + AVR) were carried out in 12.5% of patients (Group III). The mean operational risk calculated according to the logistic EuroSCORE was 11.6%, 11.9%, and 9.5%, respectively in Group I, Group II and in Group III. In the early postoperative period, 4 patients died (all from Group I). The 30-day mortality rate was 4.2% and the morbidity rate was 56.3%. During the post-discharge follow-up period that lasted from 1 to 100 months, 4 patients died (2 from Group I and 2 from Group III). The 2-year probability of survival was 91.9 ± 3.0%. During the last follow-up clinical assessment, half of the patients were asymptomatic.ConclusionsThe perioperative mortality of the patients is acceptably and markedly lower than that predicted by the logistic EuroSCORE calculator. However, the complication rate, particularly in the early postoperative period, is relatively high.

show abstract

“…La edad ha sido considerada como un factor predictivo independiente de mortalidad (132). El incremento del riesgo de estos pacientes está relacionado con cambios estructurales del corazón y con una reducción de las reservas fisiológicas de los órganos, un incremento de las enfermedades asociadas (diabetes, insuficiencia renal, hipertensión arterial, etc), la presencia de una cardiopatía avanzada con una mayor incidencia de insuficiencia cardíaca y depresión ventricular izquierda, la desnutrición, una depresión de la inmunidad celular postoperatoria y una mayor complejidad de la técnica quirúrgica asociada a tiempos de CEC prolongados (133,134).…”

Section: Características Demográficas Y Clínicasunclassified

Predicción de mortalidad en cirugía cardíaca mediante la combinación del tiempo de circulación extracorpórea, procalcitonina sérica y EuroSCORE

López¹

View full text Add to dashboard Cite

aa: Aminoácido. ABC: Área bajo la curva. APACHE II: Acute physiology and chronic health evaluation II. ATP: Angioplastia transluminal percutánea. AV: Aurículo ventricular. BCIAo: Balón de contrapulsación intraaórtico. BNP: Péptido natriurético tipo B. cAMP: Adenosin monofosfato fosfodiesterasa cíclico CDAC: Cirugía de derivación aortocoronaria. CEC: Circulación extracorpórea. CGRP: Calcitonin gene-related peptides. CK-MB: Creatinin quinasa mioglobina. cm: Centímetro cNOS: Enzima calcio dependiente óxido nítrico sintetasa. COR: Característica operativa del receptor (receiver operating characteristic) dl: Decilitro.

show abstract

Cirugía cardíaca en el anciano

Cited by 25 publications

References 15 publications

The Role of Invasive Therapies in Elderly Patients with Acute Myocardial Infarction

The Role of Invasive Therapies in Elderly Patients with Acute Myocardial Infarction

CARDIAC SURGERY Early and long-term results of cardiosurgical treatment of coronary artery disease and aortic stenosis in patients over 80 years old

Predicción de mortalidad en cirugía cardíaca mediante la combinación del tiempo de circulación extracorpórea, procalcitonina sérica y EuroSCORE

Contact Info

Product

Resources

About