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Cardiac surgery in elderly patients

BACKGROUND: Because of the increase in the life expectancy of the Brazilian population, elderly patients are being increasingly referred to cardiac surgery. MATERIAL AND METHODS: Seventy-five patients, 70 years of age or older, who underwent cardiac surgery in the HC-UFPR, between 1995 and 1999 were studied. The purpose of this study was to analyze early and long-term results. Ages from 70 to 88 years, with 34 females (46.7%) and 41 males (53.3%). Symptoms included angina (81.3%), dyspnea (42.6%) and syncope (16%). There was 57.3% of patients in NYHA class I, 17.3% in class II, 18.6% in class III and 6.6% in class IV. The main risk factors listed were high blood pressure (61.3%), smoke (48%), diabetes mellitus (28%) and 9.3% had already had cardiac operations. Surgical procedures included 50 coronary artery bypass grafts - CABG (66.6%), 9 aortic valve replacements (12%), 5 aortic operations (6.6%), 4 CABG + valve replacement (5.2%) and other procedures (7%). The main postoperative complications were cardiovascular - ventricular arrhythmias (22.6%), supraventricular arrhythmias (21.3%), low cardiac output (16%) - infections (16%) and pulmonary problems (9.3%). The median stay in the ICU was 5 days. RESULTS: Sixty-five (78.4%) survivors had complete follow-up. The mean follow-up time was 20.7 months and long-term survival was 92%. Only one of the late deaths was cardiac related. CONCLUSION: Although this subgroup is associated with chronic diseases compromising other organs, advances in cardiac surgery and intensive care have made possible an intervention with safety and low morbidity and mortality.

Aging; Cardiac surgical procedures; Heart disease; Cardiac surgical procedures


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