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Thierry Carrel
Friedrich Eckstein
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Eur J Cardiothorac Surg 2007;31:1099-1105. doi:10.1016/j.ejcts.2007.01.055
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Benefits of cardiac surgery in octogenarians — a postoperative quality of life assessment

Christoph H. Hubera,*, Volkhard Goeberb, Pascal Berdatb, Thierry Carrelb, Friedrich Ecksteinb

a Division of Cardiovascular Surgery, University Hospital of Lausanne, CHUV, Switzerland
b Division of Cardiovascular Surgery, University Hospital of Bern, Inselspital, Switzerland

Received 18 August 2006; received in revised form 26 January 2007; accepted 29 January 2007.

* Corresponding author. Address: Service de Chirurgie Cardiovasculaire, Centre Hospitalier Universitaire Vaudois CHUV, 1011 Lausanne, Switzerland. Tel.: +41 21 314 2421; fax: +41 21 314 2278. (Email: Christoph.Huber{at}hospvd.ch).

Objective: Assessment of postoperative quality of life in patients over 80 years after cardiac surgery including coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and combined procedures. Methods: Quality of life of n = 136 patients over 80 years at operation (82.3 ± 2.1 years), undergoing isolated CABG in 61 patients (45%), isolated AVR in 34 patients (25%) and a combination of CABG and AVR in 41 patients (30%) between January 1999 and December 2003 was reviewed. Preoperatively 66.2% presented in NYHA-class III/IV or CCS-class III/IV. Mean ejection fraction (EF) was 59.5% ± 14.0 (range 25–90%). Quality of life assessment was performed via a Seattle Angina Questionnaire. Follow-up was 100% complete for a total of 890 days (69–1853 days). Results: Five-year survival was 70% for the CABG group, 75% for the AVR group and 65% for the CABG/AVR group. Quality of life was remarkable in all of the three groups after surgery. Overall 97 patients (81%) were not or little disabled in their daily activity. One hundred and twelve patients (93%) were free or considerably less symptomatic. Seventy-eight patients or 65% reported to be very satisfied with their current quality of life and 112 patients (93%) felt very reassured to have continuous full access to medical treatment despite of their advanced age. Conclusions: A remarkable quality of life and important improvement in the functional status after cardiac surgery in patients over 80 paired with a satisfactory medium-term survival justify early intervention for heart disease in this age group. Therefore, referral practice for patients over 80 years for heart surgery should be handled liberally.

Key Words: Elderly • Aging • Quality of life • Valve surgery • Coronary surgery • Heart disease






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.