RESULTS OF CARDIAC-SURGERY IN THE ELDERLY USING NORMOTHERMIC TECHNIQUES

Background: Cardiac surgery is increasingly offered to older patients. A new method of myocardial protection, continuous normothermic blood cardioplegia, offers theoretical advantages over hypothermic methods b ecause it avoids ischemia. We set out to study the results of continuo us normothermic blood cardioplegia in older patients. Methods: We revi ewed the medical records of 79 patients aged 70 years or older who und erwent cardiac surgery using normothermic cardiopulmonary bypass and m yocardial protective techniques between January 1992 and August 1993. Results: The mean +/-SD age of the patients was 74+/-3 years; 46 patie nts were men and 33 were women. Coronary artery surgery was performed in 33 patients, mitral valve replacement alone in 10 and with coronary artery surgery in six, aortic valve replacement in 20, aortic valve r eplacement with coronary artery surgery in six, the Bentall procedure in one, repair of a false aneurysm of the left ventricle with coronary surgery in one, and double valve replacement with coronary artery sur gery in two. The complications were stroke in 2.5% of the patients (al l of whom recovered completely), myocardial infarction in 6%, and post operative bleeding requiring reoperation in 9%. The overall mortality was 10%. Conclusion: The morbidity and mortality for heart surgery in the elderly using continuous normothermic blood cardioplegia and normo thermic systemic cardiopulmonary bypass were comparable to those achie ved using hypothermic techniques.