PMID- 7555162
OWN - NLM
STAT- MEDLINE
DCOM- 19951108
LR  - 20190514
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 108
IP  - 4
DP  - 1995 Oct
TI  - Efficacy of combined coronary revascularization and valve procedures in 
      octogenarians.
PG  - 927-31
AB  - From January 1982 to October 1991, 42 consecutive patients 80 years of age and 
      older underwent a combined cardiac procedure with coronary revascularization and 
      valve repair or replacement. There were 20 women and 22 men. Mean age at 
      operation was 82.8 years (range, 80 to 89.7 years). Twenty-seven patients (64%) 
      were in New York Heart Association (NYHA) functional class III or IV 
      preoperatively. Six patients (14.3%) had undergone previous cardiac procedures. 
      There were six hospital deaths (14.3%). The only significant preoperative risk 
      factor identified for the event hospital death was aortic insufficiency (p = 
      0.005). The 36 hospital survivors were followed up at a mean of 21.1 months after 
      hospital discharge. There were nine (21%) late deaths occurring at a mean of 21.3 
      months postoperatively: two from acute myocardial infarctions and seven from 
      chronic heart failure. Survival analysis indicated that higher preoperative NYHA 
      class (p = 0.0003), hypertension (p = 0.015), hypercholesterolemia (p = 0.03), 
      and elevated left atrial/left ventricular gradient (p = 0.04) were incremental 
      risk factors for overall mortality. The actuarial survival at 40 months was 
      51.9%, with no significant difference as compared with an age-, sex-, and 
      race-matched population. Of the 27 late survivors, 26 were in NYHA class I or II. 
      We conclude that octogenarians may undergo complex cardiac surgical procedures 
      with an expectation of an acceptable mortality rate and significant improvement 
      in their functional status. These results must be taken into consideration in 
      light of reported strategies to ameliorate health-care costs by limiting 
      availability of complex medical care to the elderly.
FAU - Adkins, M S
AU  - Adkins MS
AD  - Department of Thoracic and Cardiovascular Surgery, Deborah Heart and Lung Center, 
      Browns Mills, NJ, USA.
FAU - Amalfitano, D
AU  - Amalfitano D
FAU - Harnum, N A
AU  - Harnum NA
FAU - Laub, G W
AU  - Laub GW
FAU - McGrath, L B
AU  - McGrath LB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - *Bioprosthesis/mortality/statistics & numerical data
MH  - *Catheterization/mortality/statistics & numerical data
MH  - Combined Modality Therapy
MH  - *Coronary Artery Bypass/mortality/statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis/mortality/statistics & numerical data
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Mitral Valve/*surgery
MH  - Postoperative Complications/epidemiology/surgery
MH  - Reoperation/statistics & numerical data
MH  - Risk Factors
MH  - Survival Rate
MH  - Time Factors
EDAT- 1995/10/01 00:00
MHDA- 1995/10/01 00:01
CRDT- 1995/10/01 00:00
PHST- 1995/10/01 00:00 [pubmed]
PHST- 1995/10/01 00:01 [medline]
PHST- 1995/10/01 00:00 [entrez]
AID - S0012-3692(15)44800-7 [pii]
AID - 10.1378/chest.108.4.927 [doi]
PST - ppublish
SO  - Chest. 1995 Oct;108(4):927-31. doi: 10.1378/chest.108.4.927.