Coronary artery bypass and valve replacement in octogenarians.
Midwest Surgical Association Meeting. Grand Traverse, Michigan (USA), 1995/08/13.
A total of 325 patients, aged 80 to 92 (mean 82), underwent cardiac operations with cardiopulmonary bypass over a 4-year period (1991-1995).
Hypothermia (22° C) and hyperkalemic cardioplegia were used in each.
Coronary bypass procedures only (Group I) were performed in 255 patients with 22 early deaths (8.6%), and the average number of grafts was 3.7 per patient.
Single or double valve replacement, with coronary bypass (Group II) was performed in 46 patients, with six early deaths (13%). Single or double valve replacement, without coronary bypass (Group III) was performed in 24 patients, with two early deaths (8.3%). Total hospital mortality was 30 deaths in 325 patients (9.2%). Fifty-six procedures (22%) from Group I and four (9%) from Group II were performed as emergencies, and all operations in Group III were elective.
Seventy-two patients (27%) from Group I, 18 patients (39%) from Group II, and nine patients (37%) from Group III had major complications including renal failure, cerebrovascular accident, myocardial infarction, postoperative hemorrhage, sepsis, and ventilatory dependency.
Mean hospital stay was 10.5 days for Group I, 13.3 days for Group II, and 15.2 days for Group III, with an overall mean of 13 days (range, 6-52) days.
Higher mortality was related to a cardiac index<1.8, cardiogenic shock, emergency operation, creatinine>2.0, and morbid obesity.
Mean left ventricular ejection fractions were 0.51 for Group I, 0.45 for Group II, and 0.49 for Group III. (...)
Mots-clés Pascal : Dérivation, Artère coronaire, Remplacement, Valvule cardiaque, Circulation extracorporelle, Morbidité, Mortalité, Etude statistique, Vieillard, Homme, Chirurgie, Appareil circulatoire pathologie, Cardiopathie coronaire, Cardiopathie valvulaire
Mots-clés Pascal anglais : Bypass, Coronary artery, Replacement, Heart valve, Cardiopulmonary bypass, Morbidity, Mortality, Statistical study, Elderly, Human, Surgery, Cardiovascular disease, Coronary heart disease, Cardiac valvular disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0022429
Code Inist : 002B25F. Création : 21/05/1997.