Cardiac surgery in nonagenarians

A. Hovanesyan, M. R. Moon, M. W. Rich

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Aim. To evaluate outcomes following cardiac surgery in nonagenarians. Methods. A retrospective analysis of patients ≥90 years of age undergoing cardiac surgery at Barnes-Jewish Hospital from 1996-2006 was performed. The Social Security Death Index was used to determine late survivaL Results. Twenty-two subjects were identified. The mean age was 91 years (range 90-94) and 64% were women. The most common comorbidities included hypertension in 91% and heart failure (HF) in 65%. Mean New York Heart Association class was 3.5, mean left ventricular ejection fraction was 50% (range 27-80%), and mean creatinine clearance was 34±11 cc /min. No patients had prior cardiac surgery. Nine patients underwent coronary bypass grafting only, 11 had valve replacement only, and 2 had both. Concurrent operations included 1 ventricular septal defect repair, 2 carotid endarterectomies, and 1 ascending aortic patch angioplasty. Two cases were urgent, 2 were emergent, and the remainder were elective. There was one intraoperative death (5%), during urgent mitral valve replacement. The most common postoperative complications included atrial fibrillation and need for vasopressors for >48 hrs. Mean length of intensive care and total hospital stay were 3.4±4.5 and 12.2±8.5 days, respectively. Independent predictors of increased hospital stay were higher serum creatinine (P=0.028) and the presence of HF (P=0.050). Survival to 30, 90 and 365 days were, respectively: 86%, 77%, and 64%. At study conclusion, 7 patients (32%) were alive at a mean follow-up of 4.1 years. Conclusion. Despite higher morbidity and mortality, in carefully selected nonagenarians referred for cardiac surgery, short-term complication rates and long-term outcomes appear to be acceptable.

Original languageEnglish
Pages (from-to)757-760
Number of pages4
JournalJournal of Cardiovascular Surgery
Volume48
Issue number6
StatePublished - Dec 2007

Keywords

  • Aged, 80 and over
  • Cardiac surgical procedures
  • Treatment, outcome

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