Turkish Journal of Geriatrics 2010 , Vol 13 (Supplement)
CARDIAC SURGERY IN ELDERLY
Ali KUTSAL
Dr. Sami Ulus Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, ANKARA The average age of the population in western countries is steadily increasing, with many people aged 70 and older are referred to surgery for coronary artery disease and degenerative cardiovascular diseases which are particularly prevalent in this population. Advanced age is associated with decreased physiologic reserve and significant comorbidity. Thorough preoperative assessment, identification of the risk factors for perioperative morbidity and mortality, and optimal preparation are critical in these patients. . Coronary artery bypass, valvular and re-do operations are performed routinely on older patients with excellent results. Medical versus surgical intervention trials are warranted in the elderly. For CAD, randomized prospective trials specific to the area of angioplasty or stent versus CABG, or angioplasty versus beating-heart surgery for single or double vessel CAD are examples of needed trials. In the surgically treated elderly patients, further trials to define long-term results of beating-heart and minimal access valve surgery are recommended. Randomized trials are especially important for CAD in the area of beating-heart surgery to identify the potential advantages of performing CABG without the use of cardiopulmonary bypass. Despite this the current data clearly indicate that no patient group is “too old” for cardiac surgery and that excellent outcomes can be achieved in selected group of elderly patients. Keywords : Surgery; Cardiac; Aging