CARDIAC SURGICAL OUTCOME IN AN OCTOGENARI AN COHORT

The number of octogenarian patients undergoing an open heart procedure in our unit is the fastest increasing group of patients. Between June 1985 and July 1994 112 octogenarians (mean age 81.7 years, 60 males, 52 females) underwent cardiac operations. The postoperative course was uneventful in 90 patients (80.4%). The perioperative mortality rate w as 8.9% (10 patients). Mortality was lowest in the group receiving aor tic valve replacement, with one death out of 30 patients (3.3%). The c ause of death was left- or biventricular heart failure in more than ha lf of the fatalities. Postoperative complications included: AV-block I II(n = 1), postoperative bleeding (n = 2), unstable sternum (n = 3), a cute cholecystitis (n = 1), low cardiac output syndrome (n = 1), strok e (n = 1), pneumothorax (n = 2) and urinary tract infections (n = 1). We consider open heart procedures in octogenarians, despite a mortalit y rate of 8.9%, as justified. According to the severity and course of clinical symptoms and the type of surgery required, selection of patie nts for operation should be decided on at an early stage of the diseas e. Not only life expectancy increases, but there is also a significant increase in life quality for these patients.