Outcome following open-heart surgery in an Oriental octagenarian population in Hawaii.

Increasingly, a surgical approach is being utilized for the management of elderly patients with ischemic or valvular heart disease. In order to further understand the outcome in this population, we performed a retrospective review of octagenarians undergoing open-heart surgery over a 2-year period. Thirteen patients were identified, with a mean age of 82.6 years. All were Oriental. Most of our patients were considered high risk, 10 of them requiring emergency surgery and 6 requiring preoperative intra-aortic balloon counterpulsation (IABP). Postoperatively, 11 of the 13 patients suffered at least 1 complication. The most frequent complications were atrial arrythmias (7 patients), a low cardiac output (5 patients), the need for prolonged ventilation (3 patients) and ventricular arrythmias (3 patients). Functionally, the patients statistically improved, from a mean preoperative classification of 3.8 (New York Heart Association Classification) (NYHA) to 1.5 at the time of discharge (p less than 0.001). All patients are still alive at the time of writing (October 1989) with a mean followup of 13.3 months. Our data show that an operative approach to heart disease can be done safely in a high risk octagenarian population. In addition, we found that a statistically significant functional improvement occurred in these patients.