Kudo M, Yozu R
Department of Surgery, Keio University, School of Medicine, Tokyo, Japan.
Kyobu Geka. 2005 Jul;58(8 Suppl):670-4.
Cardiac surgery in elderly patients are increasing in recent years. From October 1997 to December 2004, we operated on 163 patients with port-access cardiac surgery, of whom 5 were over 70 years old (elderly group) and 158 were 16-69 years old (young group). The patients were 91 with atrial septal defect (ASD), 64 with mitral valve disease, 2 with coronary artery disease (coronary artery bypass grafting : CABG), and 10 with other (ventricular septal defect : VSD, myxoma et al.). This report presents result of port-access cardiac surgery in elderly patients. No significant difference was found between 2 groups in extracorporeal time, aortic clamp time, postoperative intubation period and postoperative hospital stay. However, the transfusion rate in mitral valve lesion were higher in elderly patient (100%) than in younger ones (18%). In conclusion, it seems that port-access cardiac surgery was to be a useful for elderly patient though contraindications were accepted such as peripheral arteriosclerosis and calcification of aorta.
近年来,老年患者的心脏手术数量不断增加。1997年10月至2004年12月,我们对163例患者进行了端口入路心脏手术,其中5例年龄超过70岁(老年组),158例年龄在16 - 69岁之间(青年组)。患者中,房间隔缺损(ASD)91例,二尖瓣疾病64例,冠状动脉疾病2例(冠状动脉旁路移植术:CABG),其他疾病(室间隔缺损:VSD、黏液瘤等)10例。本报告展示了老年患者端口入路心脏手术的结果。两组在体外循环时间、主动脉阻断时间、术后插管时间和术后住院时间方面未发现显著差异。然而,老年患者二尖瓣病变的输血率(100%)高于年轻患者(18%)。总之,尽管存在外周动脉硬化和主动脉钙化等禁忌证,但端口入路心脏手术似乎对老年患者有用。