OPEN-HEART-SURGERY IN THE OCTOGENARIANS - A STUDY ON LONG-TERM SURVIVAL AND QUALITY-OF-LIFE

This retrospektive study analyzes the perioperative and longterm survi val rate as well as the long-term quality of life of 54 patients (23 f /31 m), aged 80 years or older (80 to 87, mean 82.2, SD +/- 1.79 years ), who underwent open heart surgery between January 1986 and December 1993. There were 23 patients with coronary bypass, 21 with aortic valv e replacement, 1 with mitral valve replacement, 8 with combined aortic valve replacement and coronary bypass, and 1 with double valve replac ement. Preoperatively, 26 of the patients were in New York Heart Assoc iation (NYHA) class IV, 28 patients in class III. The in-hospital mort ality was 9.3% (5/54) over all and 6.1% (3/49) for elective procedures . Follow-up time ranged from 6 to 91 months (mean 26.2+/-16.5). Of 49 discharged patients, 6 (12.2 %) died during the follow-up period. At t he time of reevaluation 21 patients were in NYHA class I, 24 patients in class II, and 4 in class III. There was a significant long-term ben efit from the surgical internvention in 39 of the 54 patients. Of 43 s urvivors 41 were able to live on their own and 38 were able to handle their daily routine without help. Two patients were cared for in a nur sing home. This long-term analysis demonstrates the benefits of cardio vascular surgery in octogenarians in terms of social integration and q uality of life.