Objective : Because the elderly are increasingly referred for operation, we reviewed results with cardiac surgical patients 80 years old or older.
Methods : Records of 170 consecutive patients 80 years old or older having cardiac operations between 1992 and 1998 were reviewed. Follow-up was 98% complete.
Results : Seventy patients had coronary grafting (CABG), 62 aortic valve replacement (AVR), 26 AVR + CABG, and 12 mitral valve repair/replacement (MVR). Rates of hospital death, stroke, and prolonged stay (> 14 days) were as follows: CABG: 7 (10%), 2 (2.8%) and 27 (38.6%); AVR: 6 (9.6%), 2 (3.2%) and 26 (42.0%); AVR + CABG: 5 (19.2%), 1 (3.8%) and 9 (34.6%); MVR: 2 (16.7%), 1 (8.3%) and 5 (31.2%). Multivariate predictors (p < 0.05) of hospital death were preoperative myocardial infarction (MI), New York Heart Association (NYHA) class and urgent procedure; predictors of stroke were carotid disease and ascending aortic atheromatous disease and predictors of prolonged stay were age, preoperative MI, and NYHA class. Actuarial 5-year survival was as follows: CABG, 67%; AVR, 78%; AVR + CABG, 62%; MVR, 58%; and total, 68%. Multivariate predictors of late death were preoperative pacing, preoperative MI, postoperative stroke, and urgent procedure. Eighty-one percent of long-term survivors were in NYHA class I or II, and 92% believed having a heart operation after age 80 years was a good choice.
Conclusions : Cardiac operations are successful in most octogenarians with increased hospital mortality, and longer hospital stay. Long-term survival and quality of life are good.