[Cardiac surgery in the aged].

One hundred and seven patients aged greater than or equal to 60 years with cardiac surgery were reviewed. These patients underwent open heart surgery at University Hospital of Tokyo and JR Tokyo General Hospital during 1981 to 1987. Prevalence of the elderly with 60 years or older in all patients with cardiac surgery increased 4.1% to 20% during these seven years. Surgery for ischemic heart disease has become more common. There were less number of cases with valvular heart disease referred for surgery, but, not a few cases with calcified aortic valve or floppy mitral valve had valve replacement. Operative results were as follows: Hospital death was 6/107 patients (5.6%) and three patients died after discharge. This group of old patients was occasionally associated (14/107, 13%) with a variety of diseases including bronchial asthma, diabetes mellitus, and other atherosclerotic lesion or liver dysfunction. Valvular heart disease was not rarely complicated with ischemic heart disease. Postoperative complications were mainly due to renal failure, respiratory failure or low output syndrome, possibly related to associated disease. Intra-aortic balloon pumping was performed in seven of 107 patients, four of whom eventually died. In conclusion, there is a relatively high risk in cardiac surgery in old aged patients with associated diseases. We have to manage carefully old patients to avoid major postoperative complications including cardiac, respiratory and renal events. Much more old patients will have open heart surgery in the future.