Urgent cardiac surgery in octogenarians

BACKGROUND: Urgent or emergent cardiac surgery in the elderly is burdened by high operative mortality and unacceptable postoperative quality of life. METHODS: From 1998 to 2007, 251 patients aged 80 years underwent nonelective cardiac surgery for urgent (n = 229) or emergent (n = 22) indications. A logistic regression to identify incremental risk factors for postoperative death was performed. RESULTS: The overall early mortality was of 12%, with 8% in urgent and 45% in emergent cases. The most frequent causes of death were infections, particularly pneumonia (23%), renal failure (20%), CVA (17%), respiratory failure (10%), and multisystem organ failure (10%). Incremental risk factors for early mortality were age, emergent procedure, aortic procedure, cardiopulmonary bypass time, and the presence of a major postoperative complication. Mean follow-up time was 5.4 +/- 3.2 years. CONCLUSIONS: An urgent cardiac surgery can be performed in octogenarians with acceptable operative mortality and good long-term survival.