PMID- 352572
OWN - NLM
STAT- MEDLINE
DCOM- 19780929
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 58
IP  - 2
DP  - 1978 Aug
TI  - Surgery using cardiopulmonary bypass in the elderly.
PG  - 250-4
AB  - This study included 89 patients, 70-82 years (mean 72.8 years), who had 
      procedures using cardiopulmonary bypass since 1955. Twenty-six patients had 
      elective aortic valve replacement (AVR), with two hospital deaths. One patient 
      who underwent emergency AVR for bacterial endocarditis died of septic shock. Ten 
      patients had AVR and coronary artery bypass surgery (CABG), with one hospital 
      death (10%). Fourteen patients had mitral valve replacement (MVR), with eight 
      hospital deaths (57%). Two died of left ventricular rupture after leaving the 
      operating room, and the remainder died of low cardiac output. Twenty-five 
      patients had CABG with no early deaths. Seven patients had aneurysms of the 
      thoracic aorta, with two early deaths. Six patients had other procedures with one 
      death, making a total of 16 operative deaths in the 89 patients. Eighty-four of 
      the patients (94%) were New York Heart Association (NYHA) Functional Class III or 
      IV for congestive heart failure and/or angina, preoperatively. Of these, 12 were 
      in extremis immediately before surgery, and six survived. There were 10 late 
      deaths. The actuarial survival rates for one, two and five years for all patients 
      were 69% (40 patients), 47% (20 patients) and 21% (seven patients), respectively. 
      At recent follow-up (mean 20 months) 84% of the hospital survivors were 
      symptomatically improved at least one NYHA Functional Class. We conclude that 
      CABG and/or AVR can be performed in elderly patients with a low hospital 
      mortality and with symptomatic improvement. However, MVR in the elderly carries 
      an unusually high mortality (7.3 times greater than patients less than 70, in our 
      experience), and this risk must be weighed when considering MVR in these 
      patients.
FAU - Stephenson, L W
AU  - Stephenson LW
FAU - MacVaugh, H 3rd
AU  - MacVaugh H 3rd
FAU - Edmunds, L H Jr
AU  - Edmunds LH Jr
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - *Aged
MH  - Aorta, Thoracic/surgery
MH  - Aortic Valve/surgery
MH  - Cardiac Output
MH  - Coronary Artery Bypass/*mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis/*mortality
MH  - Humans
MH  - Male
MH  - Mitral Valve/surgery
RF  - 52
EDAT- 1978/08/01 00:00
MHDA- 2001/03/28 10:01
CRDT- 1978/08/01 00:00
PHST- 1978/08/01 00:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1978/08/01 00:00 [entrez]
AID - 10.1161/01.cir.58.2.250 [doi]
PST - ppublish
SO  - Circulation. 1978 Aug;58(2):250-4. doi: 10.1161/01.cir.58.2.250.