CARDIAC-SURGERY IN THE VERY ELDERLY

ObjeCtive: To determine the results of cardiac surgery in the very elderly. Design and subjects: A retrospective study of 56 very elderly patients (mean age 82 years, range 79-89 years) undergoing open heart surgery between 1988 and 1991. Thirty-three patients had coronary artery bypass grafting, 12 had valve replacement alone and 11 had valve replacement with an associated procedure. Setting: St Francis Xavier Cabrini Hospital, Melbourne - a large private hospital. Results: There were four in-hospital deaths (7%). The one-year actuarial survival rate was 88%. Of the 49 survivors, 92% were in New York Heart Association (NYHA) Class III or IV before operation, whereas 96% were in NYHA Class I or II a mean of 15 months after operation. Conclusion: In very elderly patients with medically refractory cardiac symptoms, cardiac surgery has a tolerable mortality and provides excellent relief of symptoms.