Long term results of cardiac surgery in octo- and nanogenarians

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Welp, H, Galler, S, Eickmann, B, Rukosujew, A, Sindermann, J, Scheld, HH, Hoffmeier, A
• Format: Conference Proceeding
• Language: English
• Published: 01.02.2011
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-0030-1269079

Introduction: Outcomes after cardiac surgery in elderly patients become better and better. Yet some practitioners are reticent to refer elderly patients for surgery. This study analyzes long term survival in patients' aged 80 years and older undergoing cardiac surgery. Material and methods: We retrospectively analyzed patients aged over 80 years that underwent cardiac surgery between 2000 and 2009. Data were collected from medical records and hospital data base. Long term follow up was obtained from registration of address offices. Results: A total of 608 patients were included into the study. 243 patients underwent aortic valve replacement (AVR) and 365 patients had coronary artery bypass surgery (CABS). Median age in the patient population was 82 years (80 to 94 years). Median survival was 63.8 months for all patients, 66.2 months after AVR and 59.9 months after CABS. Preoperative factors significantly associated with poor long term survival in both groups were non elective indication for operation, NYHA class IV, impaired kidney function and the presence of COPD. Patients after CABS had significantly better long term survival when revascularization was complete (79.7 vs. 53.3 months; p<0.05). After AVR patient-prosthesis-mismatch had no significant influence on long term survival. Conclusion: Cardiac surgery in octo- and nanogenarians can be performed with reasonable long term results. Crucial for long term survival is the preoperative state of the patients. In patients undergoing CABS complete revascularisation is associated with significant better long term survival. After AVR undersized prosthesis had no negative influence on long term survival.