CARDIAC-SURGERY IN SEPTUAGENARIANS - POST OPERATIVE MORTALITY AND CLINICAL COURSE

The early postoperative mortality and morbidity were analyzed retrospe ctively in 134 patients, 78 male (58.2%) and 56 female (41.5%), over 7 0 years of age, undergoing coronary artery bypass operation or valvula r replacement between January 1982 and December 1991. In five cardiova scular surgery centers, 66 patients (49.3%) underwent a bypass operati on alone and 68 (50.7%) a valvular replacement, 26 (38.2%) with and 42 (61.8%) without,bypass surgery. The postoperative mortality after byp ass surgery was 7.6% (5 of 66) with a higher mortality in female than in male patients (12.5 and 6%, respectively). Reduced left ventricular function (echocardiographic and angiographic parameters) was associat ed with higher mortality. The postoperative mortality in valvular repl acement was 20.6 % (14 of 68) with a higher mortality in female than i n male patients, too (30.0 and 7.1%, respectively). Within a follow-up of 29 months, 75.4% of survivors after bypass and 79.6% after valvula r surgery had a good postoperative result. Open heart surgery in elder ly results in a higher mortality. The indication to heart operation in this age group is nevertheless justified by the symptomatic improveme nt of most of the survivors.