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八旬老人心脏手术的临床结果。

Clinical outcome of cardiac surgery in octogenarians.

作者信息

Park Man Ki, Park Seung Woo, Lee Sang-Chol, Lee Sang Hoon, Sung Kiick, Park Kay-Hyun, Lee Young Tak, Park Pyo Won

机构信息

Cardiac and Vascular Center, Samsung Medical Center, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2005 Oct;20(5):747-51. doi: 10.3346/jkms.2005.20.5.747.

DOI:10.3346/jkms.2005.20.5.747
PMID:16224146
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2779269/
Abstract

The purpose of this study was to investigate the operative results and the clinical outcomes for octogenarians who underwent cardiac surgery. Twenty consecutive octogenarians who had cardiac operations at Samsung Medical Center from October 1994 through December 2004 were included in the study. The medical records were retrospectively reviewed and the follow-up results were obtained by the interview. The patients were 15 men and 5 women, and their mean age was 83.1 yr (range: 80-89 yr). The surgical priority was urgent for 5 patients and it was elective for 15 patients. Coronary artery bypass grafting (CABG) was performed in 14 patients, valve surgery was performed in 4 patients and CABG plus valve surgery was performed in 2 patients. There was one hospital death on day one after urgent CABG in an 80-yr-old man who had left main coronary artery occlusion. There were three deaths during the follow-up. Sudden death occurred in one patient at 2 months after valve surgery, and there were two non-cardiac deaths at 12 and 14 months, respectively, after CABG. Non-fatal postoperative complications occurred in 2 of 5 urgent patients and in 3 of 15 electives. The survival rate for the 19 hospital survivors at 24 months after surgery was 80% and the mean follow-up period was 22.5 months (range: 1-58 months). In conclusion, cardiac surgery could be performed within acceptable limits of the risk and its long-term results could be expected to be favorable for the octogenarians.

摘要

本研究的目的是调查接受心脏手术的八旬老人的手术结果和临床结局。纳入研究的是1994年10月至2004年12月在三星医疗中心接受心脏手术的20例连续八旬老人。对病历进行回顾性审查,并通过访谈获得随访结果。患者中男性15例,女性5例,平均年龄83.1岁(范围:80 - 89岁)。5例患者手术优先级为急诊,15例为择期。14例患者行冠状动脉旁路移植术(CABG),4例患者行瓣膜手术,2例患者行CABG加瓣膜手术。一名80岁男性在急诊CABG术后第一天因左主干冠状动脉闭塞发生医院死亡。随访期间有3例死亡。1例患者在瓣膜手术后2个月猝死,2例患者分别在CABG术后12个月和14个月发生非心脏性死亡。5例急诊患者中有2例、15例择期患者中有3例发生非致命性术后并发症。19例住院存活患者术后24个月的生存率为80%,平均随访期为22.5个月(范围:1 - 58个月)。总之,心脏手术可以在可接受的风险范围内进行,预计八旬老人的长期手术结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/809c/2779269/3a97f5fe4aa1/jkms-20-747-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/809c/2779269/3a97f5fe4aa1/jkms-20-747-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/809c/2779269/3a97f5fe4aa1/jkms-20-747-g001.jpg

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本文引用的文献

1
Cardiac surgery in octogenarians.八旬老人的心脏手术
ANZ J Surg. 2004 Nov;74(11):983-5. doi: 10.1111/j.1445-1433.2004.03214.x.
2
Cardiac surgery for octogenarians: is it an informed decision?老年患者的心脏手术:这是一个明智的决定吗?
Am Heart J. 2004 Feb;147(2):347-53. doi: 10.1016/j.ahj.2003.05.001.
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Comparison of coronary bypass surgery with and without cardiopulmonary bypass in patients with multivessel disease.多支血管病变患者进行冠状动脉搭桥手术时体外循环使用与不使用的比较。
J Thorac Cardiovasc Surg. 2004 Jan;127(1):167-73. doi: 10.1016/j.jtcvs.2003.08.032.
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A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery.非体外循环与体外循环多支冠状动脉搭桥手术的随机对照研究。
N Engl J Med. 2004 Jan 1;350(1):21-8. doi: 10.1056/NEJMoa031282.
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Postoperative complications among octogenarians after cardiovascular surgery.八旬老人心血管手术后的术后并发症
Ann Thorac Surg. 2003 Sep;76(3):726-31. doi: 10.1016/s0003-4975(03)00676-3.
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Cardiac surgery in nonagenarians and centenarians.九旬和百岁老人的心脏手术
J Am Coll Surg. 2003 Sep;197(3):347-56; discussion 356-7. doi: 10.1016/S1072-7515(03)00384-3.
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Early and late results of cardiac and thoracic aortic surgery in octogenarians: comparison with high-risk younger patients.
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Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity.非体外循环冠状动脉旁路移植术可降低风险调整后的死亡率和发病率。
Ann Thorac Surg. 2001 Oct;72(4):1282-8; discussion 1288-9. doi: 10.1016/s0003-4975(01)03006-5.
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Off-pump coronary artery bypass. Mid-term results.非体外循环冠状动脉搭桥术。中期结果。
Jpn J Thorac Cardiovasc Surg. 2001 Jan;49(1):67-78. doi: 10.1007/BF02913127.
10
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J Am Coll Cardiol. 2000 Mar 1;35(3):731-8. doi: 10.1016/s0735-1097(99)00606-3.