OPEN-HEART-SURGERY IN OCTOGENARIANS

37 patients aged 80 or over underwent cardiac surgery during an 11-yea r period. Operative indications included angina, dyspnea and syncope. The majority of patients (n = 32) had a left ventricular ejection frac tion greater than 0.5. There were 28 aortic valve procedures, of which seven were combined with coronary artery bypass grafts (CABG), and 2 with mitral valve repair; in addition, 7 isolated CABG procedures and one isolated mitral valve repair were performed. 36-day mortality was 5.4% (2 patients); 9 patients died at a later date (2.5 to 118 months after surgery). The most frequent postoperative complications were atr ial fibrillation, pulmonary infection or atelectasis, transient deliri um and atrioventricular conduction disturbances. Mean hospital stay wa s 14.5 days. 1- and 5-year actuarial survival rates were 83% and 57%. In a control group of patients aged 60-69 matched for preoperative cha racteristics, there were no in-hospital fatalities and 1- and 5-year s urvival were, respectively 100% and 52%. Among complications, only con duction disturbances and transient delirium were significantly more fr equent in the octogenarian group. At follow-up, the proportion of seve rely symptomatic octogenarians had diminished to 24% from 84%. In conc lusion, cardiac surgery can be performed on octogenarians with adequat e myocardial reserve, exposing them to a perioperative mortality that is in the range of younger age groups while offering an equivalent pro spect for functional improvement.