Sinus rhythm is predicting outcome in midtermfollow-up in octogenarians

Objective: The aim of this study was to evaluate risk factors for 30 days mortality and long-term survival of octogenarians after cardiac surgery.

Methods: From January 2006 to June 2007 107 patients (53 male and 54 female) aged 80 or above underwent cardiac surgery with sternotomy. Patients were identified from our surgical database. Mean age was 82±3.5 years. 30 patients underwent isolated valve surgery and 29 patients isolated coronary bypass grafting (CABG). 48 patients had combined procedures. In 14 patients re-do surgery was performed. Follow-up included direct contact to the patients and their physicians. Regression analysis was performed to determine pre- and postoperative risk factors.

Results: 30 days mortality was 7.5%. Mean follow up was 34.7±5.5months with 85% one-year survival rate. Preoperative factors that influence the 30 days mortality were recent preoperative PCI (p<0.01) and impaired left ventricular function (p<0.01). Determinants of poor early outcome were postoperative myocardial infarction (p<0.001) and low cardiac output (p<0.01) as well as loss of sinusrhythm (p<0.001). The long-term survival is determined by stable sinusrhythm (p<0.01).

Conclusion: The early outcome of cardiac surgery in octogenarians was significantly influenced by preoperative PCI, impaired left ventricular function, and postoperative myocardial infarction with low cardiac output. Maintainance of sinusrhythm was associated with lower 30 days mortality and better long-term survival.