HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Probal Ghosh Robert Larbalestier Mark Edwards Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ghosh, P. Articles by Edwards, M. Search for Related Content PubMed PubMed Citation Articles by Ghosh, P. Articles by Edwards, M.

Eur J Cardiothorac Surg 1999;15:809-815
© 1999 Elsevier Science NL

Cardiac reoperations in octogenerians

The Cardiothoracic Surgical Unit, Royal Perth Hospital, Perth, Australia

Received 9 December 1998; received in revised form 22 February 1999; accepted 11 March 1999.

Corresponding author. Harav Zinger 8, Rishon Le Zion 75255, Israel; Tel.: +972-3-964 7843
e-mail: probalg{at}hotmail.com

Objective: In recent years, satisfactory outcome of primary cardiac operation in octogenerians and increased ageing of cardiac surgical population in western hospitals have led to increased expectations and referrals for reoperation. Outcome of reoperation in this aged subset was analysed. Methods: Consecutive 18 octogenerians (mean age 81.2 years, 10 men, eight women) undergoing cardiac reoperations from November 1989 through August 1998 were retrospectively reviewed. Results: They represented 6.2% of all octogenerian cardiac surgical patients and 2.7% of all reoperations during the same period. Mean preoperative NYHA class was 3.4 and Parsonnet score was 29.4. The interval to reoperation was 114.5±11.96 (4–188) months. Priority was urgent in 11 and elective in seven patients. The procedures included four AVRs, five MVRs (including two associated TVAs), six CABGs and one each of MVR with CABG, AVR with CABG and AVR, MVR and CABG. Average graft/patient was 2.3. Mean ICU stay was 4.6±1.5 (1–28) days. There was one hospital death (5.5%) on 18 pod after MVR in an 83-year-old woman. Mean postoperative stay was 20.2±5.13 (8–93) days. There were three late deaths (17.6%) – at 32 months after MVR, at 44 and 63 months after CABG. Long-term survivors were 90% among men and 50% among women who were followed up for 42.7±6.9 (9–93) months. Mean Karnofsky score in survivors at 1 year of follow-up was 78.5±2.9. Despite continued medication in all survivors, mean current NYHA is 1.9 and most have improved lifestyle. Conclusions: Satisfactory outcome may be expected after cardiac reoperations in highly selected octogenerians. However, increased procedural risks, complications, hospital stay and slower convalescence during early follow-up may be anticipated, and will indicate very careful screening. These results indicate a need to reconsider the treatment policy in primary operation with regard to choice of graft conduits and prosthetic valves in other elderly patients.

Key Words: Reoperations • Aged • Aged 80 and over • Heart diseases/surgery