Original article: cardiovascularPredictors of postoperative complications in high-risk octogenarians undergoing cardiac operations
Section snippets
Study patients
Between June 1998 and March 2001 (34 months), 73 consecutive octogenarians operated on at our Department of Cardiac Surgery were prospectively analyzed for postoperative complications. There were 32 women (43.8%) and 41 men, ranging in age from 80 to 89 years, with a mean of 83.1 ± 3.0 years and a median of 82 years.
Arterial hypertension, diabetes mellitus, obesity, and history of cigarette smoking were the most prevalent risk factors for cardiovascular disease. Symptoms of heart failure were
Results
Preoperatively, 29 patients (39.7%) were in NYHA functional class IV, and 32 (60.4%, 32 of 53) of those who had isolated or combined CABG were in CCS angina class 4. Operations were performed with urgent or emergent surgical priority in 39 patients (53.4%). All patients had European SCORE 6 or plus and 24 (32.9%) had OPR SCORE 8 or plus.
Surgical procedures included CABG in 36 patients (49.3%), valve repair or replacement in 20 (27.4%), and combined CABG and valve procedures in 17 patients
Comment
Many original articles published in the past decade show that cardiac operation in the severely symptomatic octogenarian selected on the basis of low extracardiac comorbidity can be performed with an acceptable mortality (6% to 16%), but that postoperative complications occur often (20% to 68% of patients) including transient or permanent neurologic dysfunction (10% to 14%), respiratory failure (4% to 23%), MI (0% to 5%), renal failure (2% to 13%), reoperation due to bleeding (2% to 15%),
Acknowledgements
We sincerely thank Dr Larry Bonchek for his valuable contribution to the language-editing of this manuscript.
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