Clinical Medicine Insights: Geriatrics

Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Abstract

Introduction: This study was undertaken to analyze the risk of peri-operative mortality and morbidity after Cardiac Surgery with Cardio-pulmonary Bypass (CPB) in Patients above 85 years of age.

Patients and Methods: Between 1/2001 and 05/2005 thirty-nine patients   85 years of age at the time of surgery were examined. Median age was 87 years (85–92), 13 were males and 26 were females. 11 (28%) were urgent cases, and 4 (10%) considered as emergencies. 12 (32.5%) received CABG, 14 (35%) aortic valve replacement and in 10 (25%) a combination of the both was performed. The remaining had a combination of CABG with other operations.

Results: Peri-operative mortality was 7.7% (3 pts). All were in the emergency group. One of them went into the OR under cardio-pulmonary resuscitation and died in the OR. The other two were urgent cases who died later in the ICU due to cardiac failure. Temporary neurological dysfunction (TND) was found in 10.3% (4 pts) of the survivers. Mean mechanical ventilation time was 1.5 days, mean ICU stay was 3 days and mean hospital stay 9 days.

Conclusion: Cardiac surgery with CPB in Octogenarians can be performed with an acceptable mortality in elective patients, but is associated with a dismal outcome under emergency conditions.