Cause of late death after cardiac surgery in the very elderly: a single institution experience.

OBJECTIVES: The referrals of elderly for cardiac surgery are increasing. The aim of this retrospective study is to review the long-term survival and to identify causes of late death in elderly after cardiac surgery. DESIGN: Between 1990 and 1993, 130 octogenarians underwent cardiac surgery in our department. A majority (88%) had elective surgery. One hundred and nine patients (84%) were in New York Heart Association functional class III or IV, preoperatively. Mean follow-up time was 5.4 +/- 2.5 years (range 0-10 years). Follow-up was 100% complete. RESULTS: Hospital mortality was 3.8% (5/130). Actuarial survival at 1 and 5 years were 90.0 +/- 2.6% (n = 117) and 62.3 +/- 4.3% (n = 81), respectively. Forty-six operative survivors died from cardiac-related death during follow-up. Multivariate predictors of postoperative death were higher age, poor left ventricular ejection fraction, preoperative renal insufficiency and combined surgical procedures. CONCLUSION: Our results in this paper indicate that cardiac-related mortality represents the majority of late deaths after cardiac surgery in octogenarians