Heart surgery in patients older than 70 years
Between 1980 and 1983, 103 patients over the age of seventy (average 72.5 years) underwent cardiac surgery. It comprised 41 aortic valve replacements, 11 mitral valve operations, 7 aortic and mitral valve procedures, 18 valve replacements with concomitant coronary artery bypass grafting, 17 coronary revascularizations, 7 operations for VSD after acute myocardial infarction and 2 procedures for dissecting aneurysm of the ascending aorta. Early mortality was 7.8% and late mortality 10% after a mean follow-up of 29.3 months. Preoperative NYHA-class IV is an incremental risk factor for early and later cardiac death. Early and late results are very satisfactory in patients with isolated valvular lesion, with or without concomitant coronary artery disease, and for isolated coronary atherosclerotic heart disease, whereas there is a high risk of early and late death in patients with multiple valvular lesions or VSD after acute myocardial infarction.