Is cardiac surgery now a geriatric specialty?

Like all medical specialties that deal with degenerative disease, cardiac surgery is increasingly being offered to older patients. This is driven by longer life expectancy, an increase in the prevalence of degenerative cardiac lesions, a substantial improvement in cardiac surgical results and competition from interventional cardiology in younger patient groups. Although there is no agreed definition of "geriatric", decision-making and the conduct of surgery and postoperative care in the elderly all require some modification of strategy to ensure the best results. Excellent outcomes can now be achieved (albeit at greater financial cost) in the older population, and these results hold well in the long term. Current trends suggest that both the provision and range of cardiac surgical services for the elderly may increase further. Despite this, there is still evidence of reluctance in considering older patients for cardiac surgery.