[Cardiac surgery in Portuguese octogenarians].

The purpose of this study was to investigate the operative results and the clinical outcomes of Portuguese octogenarians who underwent cardiac surgery. Records of 339 consecutive octogenarians who had had cardiac operations between 2003 and 2005 were reviewed. The effect of cardiac and operative risk factors on mortality was evaluated. Selected variables included risk factors, cardiac status, preoperative hemodynamics and surgical procedures were collected on all patients. The mean age was 82.4+/-2.4 years-old (range 80-94) and 51.9% were male. Octogenarians had often diabetes (23.6%), renal failure (5.9%), cerebrovascular disease (8.3%), peripheral vascular disease (16.5%) and chronic lung disease (10.0%). The surgical priority was elective for 206 patients, urgent for 120 patients and it was emergent for 8 patients. Coronary artery bypass grafting was performed in 46.9%of patients, valve surgery was performed in 31.6% and combination of these in 19.5% of patients. Overall hospital mortality was 10.0%. Operative mortality for coronary artery bypass and valve surgery were 9.4% and 8.0%, respectively. Combined surgery (16.7%), diabetes (15.7% vs 9.3%, p<0.05), and urgent/emergent (14.3% vs 7.3%, p<0,05) increased significantly operative mortality. In conclusion, cardiac surgery can be performed within acceptable limits of risk and an acceptable mortality. Several factors might help both in case selection and in perioperative decisions.