HEART-SURGERY IN THE ELDERLY

Between January 1987 and January 1990, 115 patients aged over 70 (mean: 75 +/- 3 years) underwent heart surgery performed by our team. Fifty-three had coronary artery bypass graft surgery alone, 44 had cardiac valve surgery alone and 18 had combined coronary and cardiac valve surgery; 88 percent of the patients were in NYHA functional class III or IV, and 79 percent presented with left ventricular dysfunction. The early postoperative mortality rate was 7 percent: 5.6 percent in coronary bypass surgery alone, 8 percent in cardiac valve surgery alone and 22 percent in combined coronary and valve surgery. After a mean follow-up period of 22 +/- 8 months, 85 percent of the patients are asymptomatic or exhibit few symptoms. The actuarial survival rate at 3 years is 78 +/- 10 percent. Thus, in 1990 age is lo longer an obstacle to heart surgery. In most cases the operative risk is controlled by a surgical strategy where the physiopathology of the elderly is taken into account and the appropriate surgical techniques are applied.