PP45 - Octogenarians – A growing population in cardiac surgery

Abstract

Octogenarians are a growing population of patients who are candidates for cardiac surgery. The author analyses a single centre experience with patients over 80 years of age who underwent cardiac surgery. A retrospective observational study was performed at the University Hospital in the period from 2011 to 2015. During that period 2139 heart operations were performed; authors compared preoperative, intraoperative and postoperative data of 1890 patients younger than 80 with group of octogenarian (123 patients over 80 years underwent cardiac procedures). There where 123 (6%) patients 80 years old or older. Sixty-five percent (65%) of the procedures were elective, 29% emergency and 6% urgent. Coronary artery bypass grafting was performed in 37% of patients, aortic valve replacement surgery in 31%, interventions involving the mitral valve in 3%, two procedures (CABG+AVR, CABG+MVR or AVR+MVR) in 22% and other procedures in 6%. The mean age of the patients was 81 (80-88 range). Octogenarian had a statistically higher Euroscore (p<0,001), more COPD (p<0,05), diabetes mellitus type 2 (p<0,05) and malignancies (p<0,01). There was no statistical difference in the operation time, CPB time and clamp time. Postoperative (cumulative) time in ICU was higher in octogenarian group (p<0,01); ventilator time was longer (p<0,01) there were more respiratory complications (p<0,01) and tracheotomies (p<0,05). Octogenarian received more transfusions. (p<0,01). Although their physical status was heavily burdened with preoperative comorbidities (8 patients had a cerebrovascular insult (7%), 16 (13%) some kind of vascular surgery, 10 (8%) COPD, 34 (28%) atrial fibrillation, 28 (23%) myocardial infarction, 96 (78%) hypertension, 29 (24%) diabetes, 24 (20%), various degrees of renal insufficiency, 2 patients (1.63%) were on haemodialysis, mortality was low- one patient died (0,8%). Octogenarians are a growing population of patients undergoing cardiac surgery. These patients often present multiple comorbidities that put them in a higher risk category. However, improvements in surgical technique, CPB technology and perioperative management enable us to perform cardiac surgery procedures in a safe manner.