RE-DO CARDIAC-SURGERY IN PATIENTS OVER 70 YEARS OLD

Objective: This study was conducted in order to determine the outcome of cardiac re-operations In patients over the age of 70, Methods: All patients who underwent 're-do' cardiac surgery at our institution, bet ween January 1987 and October 1995 were identified. The case notes of patients over the age of 70 were reviewed retrospectively and follow-u p was by telephone. Results: A total of 687 re-do operations were perf ormed during this 8 years and 9 months period. Operations, 110 (16%) w ere on patients aged 70 years and over (CABG 54, MVR 32, AVR 9, AVR+MV R 5, MVR+CABG 4, AVR+CABG 3, repair of paraprosthetic leak 2 and closu re of VSD I), Operations, 63 (57%) were elective and 42 (38%) were urg ent. The median age was 73 years (range 70-82) and 64 patients (58%) w ere male. Pre-operatively, 78 patients (72%) were NYHA functional clas s III/IV and 55 (50%) had angiographically impaired left ventricular f unction (ejection fraction < 50%). The overall operative mortality was 7% (8/110). Median ITU stay was one night (range 1-21) and hospital s tay was 7 days (range 5-35). Major in-hospital complications included resternotomy in five patients (5%), permanent stroke in three (3%), re nal failure requiring haemodialysis in two (2%) and heart block requir ing permanent pacing in two (2%). At a median follow-up of 34 months ( range 2-101), 69 of the 77 patients alive at follow-up (90%) were NYHA functional class I/II. Conclusions: 'Re-do' cardiac surgery in patien ts over the age of 70 carries an acceptable operative morbidity and mo rtality with a good functional improvement at medium term follow-up. ( C) 1997 Elsevier Science B.V.