Abstract
| Lingua originale | English |
|---|---|
| pagine (da-a) | 725-731 |
| Numero di pagine | 7 |
| Rivista | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 141 |
| Stato di pubblicazione | Published - 2011 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
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Short-term and long-term results of cardiac surgery in elderly and very elderly patients. / Fattouch, Khalil; Cristell, Donald; Nasso, Giuseppe; Popoff, Georges; Zussa, Claudio; Speziale, Giuseppe; Greco, Ernesto; Tavazzi, Luigi; Argano, Vincenzo; Chierchia, Sergio; Barattoni, Maria Cristina; Caldarola, Pasquale; Scorcin, Marcio; Esposito, Giampiero; Coppola, Roberto; Marchese, Alfredo.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 141, 2011, pag. 725-731.Risultato della ricerca: Article
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TY - JOUR
T1 - Short-term and long-term results of cardiac surgery in elderly and very elderly patients
AU - Fattouch, Khalil
AU - Cristell, Donald
AU - Nasso, Giuseppe
AU - Popoff, Georges
AU - Zussa, Claudio
AU - Speziale, Giuseppe
AU - Greco, Ernesto
AU - Tavazzi, Luigi
AU - Argano, Vincenzo
AU - Chierchia, Sergio
AU - Barattoni, Maria Cristina
AU - Caldarola, Pasquale
AU - Scorcin, Marcio
AU - Esposito, Giampiero
AU - Coppola, Roberto
AU - Marchese, Alfredo
PY - 2011
Y1 - 2011
N2 - Objective: Cardiac operations in elderly patients are increasingly frequent and imply major clinical, ethical, and economic issues. Operative and 5-year results of cardiac operations in patients aged 79 years or more are known in limited series, and a debate is ongoing on the appropriateness of selection of patients for surgery. Methods: We retrospectively reviewed our experience in 6802 patients aged 79 years or more who had received a cardiac operation. Surgical candidates were selected according to functional status, crude operative risk, and social context and were managed according to a multimodality protocol. Results: Mean age was 82 years and surgery was nonelective in 1613 cases (23.5%, 31 salvage). Procedures consisted of valve replacement (aortic, 2817; mitral, 532; and tricuspid, 2 cases), valve repair (aortic, 66; mitral, 532; and tricuspid, 232 cases), coronary bypass grafting (12,034 coronary vessels bypassed), and replacement of the thoracic aorta (ascending, 315; arch, 28 cases). Overall operative mortality was 3.4%. Nonelective presentation, need for aortic counterpulsation, cardiopulmonary bypass time, blood transfusion, depressed systolic function, and chronic lung disease predicted operative mortality. Five-year cumulative mortality was 7.5%. Poor systolic function, previous myocardial infarction, and combined coronary/mitral surgery predicted late mortality. The operative risk of nonagenarians operated on electively did not differ from that of risk-matched octogenarians. Conclusions: Cardiac surgery in elderly and very elderly patients can be performed with acceptable mortality provided that accurate selection and a multifactorial risk evaluation are adopted. Whenever possible, nonelective operations should be avoided and earlier surgery should be encouraged. Five-year survival and functional recovery are good. Copyright © 2011 by The American Association for Thoracic Surgery.
AB - Objective: Cardiac operations in elderly patients are increasingly frequent and imply major clinical, ethical, and economic issues. Operative and 5-year results of cardiac operations in patients aged 79 years or more are known in limited series, and a debate is ongoing on the appropriateness of selection of patients for surgery. Methods: We retrospectively reviewed our experience in 6802 patients aged 79 years or more who had received a cardiac operation. Surgical candidates were selected according to functional status, crude operative risk, and social context and were managed according to a multimodality protocol. Results: Mean age was 82 years and surgery was nonelective in 1613 cases (23.5%, 31 salvage). Procedures consisted of valve replacement (aortic, 2817; mitral, 532; and tricuspid, 2 cases), valve repair (aortic, 66; mitral, 532; and tricuspid, 232 cases), coronary bypass grafting (12,034 coronary vessels bypassed), and replacement of the thoracic aorta (ascending, 315; arch, 28 cases). Overall operative mortality was 3.4%. Nonelective presentation, need for aortic counterpulsation, cardiopulmonary bypass time, blood transfusion, depressed systolic function, and chronic lung disease predicted operative mortality. Five-year cumulative mortality was 7.5%. Poor systolic function, previous myocardial infarction, and combined coronary/mitral surgery predicted late mortality. The operative risk of nonagenarians operated on electively did not differ from that of risk-matched octogenarians. Conclusions: Cardiac surgery in elderly and very elderly patients can be performed with acceptable mortality provided that accurate selection and a multifactorial risk evaluation are adopted. Whenever possible, nonelective operations should be avoided and earlier surgery should be encouraged. Five-year survival and functional recovery are good. Copyright © 2011 by The American Association for Thoracic Surgery.
UR - http://hdl.handle.net/10447/120239
M3 - Article
VL - 141
SP - 725
EP - 731
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
ER -