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Original Articles: Adult Cardiac

Cardiac Reoperation in Patients Aged 80 Years and Older

Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany

Accepted for publication January 20, 2009.

^_* Address correspondence to Dr Krane, German Heart Center Munich, Department of Cardiovascular Surgery, Lazarettstr 36, Munich, 80636, Germany (Email: krane{at}dhm.mhn.de).

Background: The benefit of cardiac surgery in octogenarians is well described. Today, nearly every second patient who undergoes cardiac surgery is older than 70 years. The time between primary cardiac surgery and reoperation is 7 to 13 years. Therefore, in the future we can expect to see an increasing number of reoperations in octogenarians.

Methods: We studied 71 patients (41 male) with a mean age of 83 ± 2.8 years, who underwent cardiac reoperation between 1994 and 2006. These patients were compared with 71 octogenarians who underwent primary cardiac operation. Patients were matched for age, sex, year of operation, and surgical procedure. Demographic profiles, operative data, long-term survival, and quality of life by the Short-Form 36-Item Health Survey questionnaire were analyzed.

Results: Average time between previous operation and reoperation was 10.8 ± 5.6 years (range: 1.7 to 30.6). The 30-day mortality rate was 14.7% in the reoperation group and 8.5% (p = 0.43) in the control group. Actuarial survival at 1, 3, and 6 years was 71% ± 5.5%, 60.5% ± 6.1%, and 30% ± 8.1% for patients who underwent cardiac reoperation; and 77.2% ± 5%, 58.3% ± 6.3%, and 36.3% ± 7.8% for matched octogenarians who underwent primary cardiac surgery (p = 0.68). No significant differences were found between groups regarding the physical health summarized score (40.7 ± 9.4 versus 39.1 ± 10; p = 0.55) and the mental health summarized score (51.9 ± 10.9 versus 48 ± 12.9; p = 0.24) of the Short-Form 36-Item Health Survey questionnaire.

Conclusions: Octogenarians exhibit a similar long-term survival and quality of life after primary and redo cardiac surgery. Therefore, cardiac reoperation should not be a contraindication per se in octogenarians.

Related Article

Invited Commentary

Thomas E. MacGillivray
Ann. Thorac. Surg. 2009 87: 1385. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				M. Krane, B. Voss, A. Hiebinger, M. A. Deutsch, M. Wottke, A. Hapfelmeier, C. C. Badiu, R. Bauernschmitt, and R. Lange Twenty Years of Cardiac Surgery in Patients Aged 80 Years and Older: Risks and Benefits Ann. Thorac. Surg., February 1, 2011; 91(2): 506 - 513. [Abstract] [Full Text] [PDF]

				G. Rizzoli, J. Bejko, T. Bottio, V. Tarzia, and G. Gerosa Valve surgery in octogenarians: does it prolong life? Eur J Cardiothorac Surg, May 1, 2010; 37(5): 1047 - 1055. [Abstract] [Full Text] [PDF]

				T. E. MacGillivray Invited Commentary Ann. Thorac. Surg., May 1, 2009; 87(5): 1385 - 1385. [Full Text] [PDF]