In Germany, approximately 100,000 patients underwent cardiac surgery in 2005. The most important postoperative problems with prognostic impact for these patients were acute heart failure, acute renal failure, infections, neurological complications, postcardiotomy syndrome, cardiac tamponade and atrial fibrillation. The "EuroSCORE" is a relevant predictor of immediate and long-term outcome in these patients. The patency rates of coronary artery bypass grafts (CABG) are important for the long-term outcome in such surgery. There has been a significant increase in the number of patients aged 80 years and older who are referred for cardiac surgery, which is an outstanding challenge for cardiac surgeons.