| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;67:1104-1110
© 1999 The Society of Thoracic Surgeons
a Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
Accepted for publication November 4, 1998.
Address reprint requests to Dr Puskas, Emory Clinic, 550 Peachtree St, NE, Suite 7700, Atlanta, GA 30365
Background. Cardiac valve replacement and coronary artery bypass graft surgery (CABG) are being applied with increasing frequency in patients 80 years of age and older.
Methods. Six hundred one consecutive patients older than 80 years, undergoing cardiac surgery between 1976 and 1994 (CABG with saphenous vein graft, 329 [54.7%]; CABG with left internal mammary artery, 101 [16.8%]; CABG + valve, 80 [13.3%]; isolated aortic valve replacement, 71 [11.8%]; isolated mitral valve replacement, 18 [3.0%]), were studied retrospectively to assess short- and long-term survival. They were compared with 11,386 patients aged 60 to 69 years and 5,698 patients aged 70 to 79 years undergoing similar procedures during the same time interval.
Results. In comparison with patients 60 to 69 years old, more octogenarians were women (44.4% versus 25.6%, p < 0.0001), had class IV angina (54.1% versus 38.9%, p < 0.0001), and had congestive heart failure class IV (4.9% versus 3.0%, p = 0.0001). In-hospital death rates (9.1% versus 3.4%, p < 0.0001) and stroke (5.7% versus 2.6%, p < 0.0001) reflected these adverse clinical risk factors. However, Q-wave infarction tended to be less frequent (1.5% versus 2.6%, p = 0.102). Interestingly, hospital mortality (9.1% versus 6.7%, p = 0.028) was only slightly increased, and stroke (5.7% versus 4.7%, p = 0.286) was not more common in octogenarians than in patients 70 to 79 years old. Late-survival curves have similar slopes for the first 5 years in all clinical subgroups. However, after 5 years there is a more rapid decline in octogenarians than in younger age groups. Median 5-year survival was 55% for patients older than 80 years, 69% for patients 70 to 79 years, and 81% for patients 60 to 69 years old.
Conclusions. When appropriately applied in selected octogenarians, cardiac surgery can be performed with acceptable mortality and excellent 5-year survival.
This article has been cited by other articles:
|
|
 |
|
  T. Walther, V. Falk, M. A. Borger, J. Kempfert, J. Ender, A. Linke, G. Schuler, and F. W. Mohr Transapical aortic valve implantation in patients requiring redo surgery Eur. J. Cardiothorac. Surg., August 1, 2009; 36(2): 231 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Maisano, G. Vigano, C. Calabrese, M. Taramasso, P. Denti, A. Blasio, A. Guidotti, and O. Alfieri Quality of life of elderly patients following valve surgery for chronic organic mitral regurgitation Eur. J. Cardiothorac. Surg., August 1, 2009; 36(2): 261 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Krane, R. Bauernschmitt, A. Hiebinger, M. Wottke, B. Voss, C. C. Badiu, and R. Lange Cardiac reoperation in patients aged 80 years and older. Ann. Thorac. Surg., May 1, 2009; 87(5): 1379 - 1385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Maleszka, G. Kleikamp, A. Zittermann, M. R.G. Serrano, and R. Koerfer Simultaneous Aortic and Mitral Valve Replacement in Octogenarians: A Viable Option? Ann. Thorac. Surg., December 1, 2008; 86(6): 1804 - 1808. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. H. Thourani, R. Myung, P. Kilgo, K. Thompson, J. D. Puskas, O. M. Lattouf, W. A. Cooper, J. D. Vega, E. P. Chen, and R. A. Guyton Long-Term Outcomes After Isolated Aortic Valve Replacement in Octogenarians: A Modern Perspective Ann. Thorac. Surg., November 1, 2008; 86(5): 1458 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Ngaage, M. E. Cowen, S. Griffin, L. Guvendik, and A. R. Cale Early neurological complications after coronary artery bypass grafting and valve surgery in octogenarians Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 653 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. de Vincentiis, A. B. Kunkl, S. Trimarchi, P. Gagliardotto, A. Frigiola, L. Menicanti, and M. Di Donato Aortic Valve Replacement in Octogenarians: Is Biologic Valve the Unique Solution? Ann. Thorac. Surg., April 1, 2008; 85(4): 1296 - 1301. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Dacey, D. S. Likosky, T. J. Ryan Jr, J. F. Robb, R. D. Quinn, J. T. DeVries, M. J. Hearne, B. J. Leavitt, R. F. Dunton, R. A. Clough, et al. Long-Term Survival After Surgery Versus Percutaneous Intervention in Octogenarians With Multivessel Coronary Disease Ann. Thorac. Surg., December 1, 2007; 84(6): 1904 - 1911. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Basaran, O. Selimoglu, H. Ozcan, H. Ogus, E. Kafali, C. Ozcelebi, and T. N. Ogus Being an elderly woman: is it a risk factor for morbidity after coronary artery bypass surgery? Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 58 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Melby, A. Zierer, S. P. Kaiser, T. J. Guthrie, J. D. Keune, R. B. Schuessler, M. K. Pasque, J. S. Lawton, N. Moazami, M. R. Moon, et al. Aortic Valve Replacement in Octogenarians: Risk Factors for Early and Late Mortality Ann. Thorac. Surg., May 1, 2007; 83(5): 1651 - 1657. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. G. Levy Praschker, P. Leprince, N. Bonnet, A. Rama, V. Bors, L. Lievre, A. Pavie, and I. Gandjbakhch Cardiac surgery in nonagenarians: hospital mortality and long-term follow-up Interactive CardioVascular and Thoracic Surgery, December 1, 2006; 5(6): 696 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Motallebzadeh, J. M. Bland, H. S. Markus, J. C. Kaski, and M. Jahangiri Health-Related Quality of Life Outcome After On-Pump Versus Off-Pump Coronary Artery Bypass Graft Surgery: A Prospective Randomized Study Ann. Thorac. Surg., August 1, 2006; 82(2): 615 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Detaint, T. M. Sundt, V. T. Nkomo, C. G. Scott, A. J. Tajik, H. V. Schaff, and M. Enriquez-Sarano Surgical Correction of Mitral Regurgitation in the Elderly: Outcomes and Recent Improvements Circulation, July 25, 2006; 114(4): 265 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Kaufman, J. K. Shim, and A. J. Russ Old age, life extension, and the character of medical choice. J. Gerontol. B. Psychol. Sci. Soc. Sci., July 1, 2006; 61(4): S175 - S184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. M. Johnson, J. M. Smith, S. E. Woods, M. P. Hendy, and L. F. Hiratzka Cardiac Surgery in Octogenarians: Does Age Alone Influence Outcomes? Arch Surg, November 1, 2005; 140(11): 1089 - 1093. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Liistro, K. Ducci, G. Falsini, and L. Bolognese Early invasive strategy in elderly patients with non-ST-elevation acute coronary syndromes Eur. Heart J. Suppl., October 1, 2005; 7(suppl_K): K23 - K25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Liistro, P Angioli, G Falsini, K Ducci, S Baldassarre, A Burali, and L Bolognese Early invasive strategy in elderly patients with non-ST elevation acute coronary syndrome: comparison with younger patients regarding 30 day and long term outcome Heart, October 1, 2005; 91(10): 1284 - 1288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Nagendran, C. Norris, A. Maitland, A. Koshal, and D. B. Ross Is mitral valve surgery safe in octogenarians? Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 83 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Matsuura, J. Kobayashi, O. Tagusari, K. Bando, K. Niwaya, H. Nakajima, T. Yagihara, and S. Kitamura Off-Pump Coronary Artery Bypass Grafting Using Only Arterial Grafts in Elderly Patients Ann. Thorac. Surg., July 1, 2005; 80(1): 144 - 148. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Baskett, K. Buth, W. Ghali, C. Norris, T. Maas, A. Maitland, D. Ross, R. Forgie, and G. Hirsch Outcomes in octogenarians undergoing coronary artery bypass grafting Can. Med. Assoc. J., April 26, 2005; 172(9): 1183 - 1186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Collart, H. Feier, F. Kerbaul, A. Mouly-Bandini, A. Riberi, T. G. Mesana, and D. Metras Valvular surgery in octogenarians: operative risks factors, evaluation of Euroscore and long term results Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 276 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mortasawi, B. Arnrich, J. Walter, I. Frerichs, U. Rosendahl, and J. Ennker Impact of Age on The Results of Coronary Artery Bypass Grafting Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 324 - 329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Kaufman, J. K. Shim, and A. J. Russ Revisiting the Biomedicalization of Aging: Clinical Trends and Ethical Challenges Gerontologist, December 1, 2004; 44(6): 731 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Weissman Pulmonary Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 185 - 211. [Abstract] [PDF]
|
|
|
|
 |
|
 Y. M. Ganushchak, E. J. Fransen, C. Visser, D. S. de Jong, and J. G. Maessen Neurological Complications After Coronary Artery Bypass Grafting Related to the Performance of Cardiopulmonary Bypass Chest, June 1, 2004; 125(6): 2196 - 2205. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Stolz, T. Gerriets, A. Kluge, W.-P. Klovekorn, M. Kaps, and G. Bachmann Diffusion-Weighted Magnetic Resonance Imaging and Neurobiochemical Markers After Aortic Valve Replacement: Implications for Future Neuroprotective Trials? Stroke, April 1, 2004; 35(4): 888 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Northrup III, R. W. Emery, D. M. Nicoloff, T. J. Lillehei, A. R. Holter, and D. P. Blake Opposite trends in coronary artery and valve surgery in a large multisurgeon practice, 1979-1999 Ann. Thorac. Surg., February 1, 2004; 77(2): 488 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Muneretto, G. Bisleri, A. Negri, J. Manfredi, E. Carone, J. A. Morgan, M. Metra, and L. Dei Cas Left internal thoracic artery-radial artery composite grafts as the technique of choice for myocardial revascularization in elderly patients: A prospective randomized evaluation J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 179 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Muneretto, G. Bisleri, A. Negri, J. Manfredi, M. Metra, S. Nodari, L. Culot, and L. Dei Cas Total Arterial Myocardial Revascularization With Composite Grafts Improves Results of Coronary Surgery in Elderly: A Prospective Randomized Comparison With Conventional Coronary Artery Bypass Surgery Circulation, September 9, 2003; 108(90101): II-29 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kurlansky, D. B. Williams, E. A. Traad, R. G. Carrillo, J. S. Schor, M. Zucker, S. Singer, and G. Ebra Arterial grafting results in reduced operative mortality and enhanced long-term quality of life in octogenarians Ann. Thorac. Surg., August 1, 2003; 76(2): 418 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Muneretto, A. Negri, G. Bisleri, J. Manfredi, A. Terrini, M. Metra, S. Nodari, and L. D. Cas Is total arterial myocardial revascularization with composite grafts a safe and useful procedure in the elderly? Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 657 - 664. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Bacchetta, W. Ko, L. N. Girardi, C. A. Mack, K. H. Krieger, O. W. Isom, and L. Y. Lee Outcomes of cardiac surgery in nonagenarians: a 10-year experience Ann. Thorac. Surg., April 1, 2003; 75(4): 1215 - 1220. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. J. Woo and T. J. Gardner Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607. [Full Text]
|
|
|
|
|
|
S. J. Hoff, S. K. Ball, W. H. Coltharp, D. M. Glassford Jr, J. W. Lea IV, and M. R. Petracek Coronary artery bypass in patients 80 years and over: is off-pump the operation of choice? Ann. Thorac. Surg., October 1, 2002; 74(4): S1340 - 1343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Engoren, C. Arslanian-Engoren, D. Steckel, J. Neihardt, and N. Fenn-Buderer Cost, Outcome, and Functional Status in Octogenarians and Septuagenarians After Cardiac Surgery Chest, October 1, 2002; 122(4): 1309 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Gatti, G. Cardu, A. M. Lusa, and P. Pugliese Predictors of postoperative complications in high-risk octogenarians undergoing cardiac operations Ann. Thorac. Surg., September 1, 2002; 74(3): 671 - 677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. V. Potapov, H. R. Zurbrugg, C. Herzke, S. Srock, H. Riess, R. Sodian, S. Hubler, and R. Hetzer Impact of cardiac surgery using cardiopulmonary bypass on course of chronic lymphatic leukemia: a case-control study Ann. Thorac. Surg., August 1, 2002; 74(2): 384 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Ascione, K. Rees, K. Santo, M.H. Chamberlain, G. Marchetto, F. Taylor, and G.D. Angelini Coronary artery bypass grafting in patients over 70 years old: the influence of age and surgical technique on early and mid-term clinical outcomes Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 124 - 128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Kawachi, A. Nakashima, Y. Toshima, S. Kimura, and K. Arinaga Outcome of Cardiac and Thoracic Aortic Operation in Patients Over 80 Years Old Asian Cardiovasc Thorac Ann, March 1, 2002; 10(1): 12 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Smith, A. Lamy, H. M. Arthur, A. Gafni, and R. Kent Outcomes and costs of coronary artery bypass grafting: comparison between octogenarians and septuagenarians at a tertiary care centre Can. Med. Assoc. J., September 1, 2001; 165(6): 759 - 764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. Skinner, K. J. West, M. Jasinski, and T. J. Spyt Cardiac surgery in octogenarians with poor lung function. Ann. Thorac. Surg., June 1, 2001; 71(6): 2084 - 2085. [Full Text] [PDF]
|
|
|
|
|
|
S. C. Stamou and P. J. Corso Coronary revascularization without cardiopulmonary bypass in high-risk patients: a route to the future Ann. Thorac. Surg., March 1, 2001; 71(3): 1056 - 1061. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kilo, H. Baumer, M. Czerny, M. J. Hiesmayr, M. Ploner, E. Wolner, and M. Grimm Target vessel revascularization without cardiopulmonary bypass in elderly high-risk patients Ann. Thorac. Surg., February 1, 2001; 71(2): 537 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Avery II, S. J. Ley, J. D. Hill, J. J. Hershon, and S. E. Dick Cardiac surgery in the octogenarian: evaluation of risk, cost, and outcome Ann. Thorac. Surg., February 1, 2001; 71(2): 591 - 596. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ricci, H. L. Karamanoukian, R. Abraham, K. Von Fricken, G. D'Ancona, S. Choi, J. Bergsland, and T. A. Salerno Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass Ann. Thorac. Surg., May 1, 2000; 69(5): 1471 - 1475. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Stamou, G. Dangas, M. K.C. Dullum, A. J. Pfister, S. W. Boyce, A. S. Bafi, J. M. Garcia, and P. J. Corso Beating heart surgery in octogenarians: perioperative outcome and comparison with younger age groups Ann. Thorac. Surg., April 1, 2000; 69(4): 1140 - 1145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Asimakopoulos and K. M. Taylor Octogenarians and cardiac surgery Ann. Thorac. Surg., January 1, 2000; 69(1): 317 - 318. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
