Open-Heart Surgery Works For Elderly Patients
Posted on: Tuesday, 11 November 2008, 12:56 CST
Survival rates are on the rise among elderly patients who undergo open-heart surgery, according to new studies.
In the past, doctors were more likely to give elderly patients medication to ease their symptoms rather than taking the risk of putting them under the knife.
Dr. Harlan Krumholz, a Yale University cardiologist who has researched older heart patients, said: "Age itself shouldn't be an automatic exclusion," adding that even 90-year-olds are having open-heart surgery.
Today, "we have elderly folks who are extremely viable, mentally quite sharp," who want to decide for themselves whether to take the risk, said Dr. Vincent Bufalino, a cardiologist at Loyola University in Chicago.
Treatment guidelines by the heart association and other groups do not have age cutoffs for such operations. It's been up to patients, doctors and insurers to decide whether to risk it.
Dr. Paul Kurlansky led a study of 1,062 octogenarians who had heart bypass surgery at Mount Sinai Medical Center in Miami Beach from 1989 through 2001.
The studies were reported at an American Heart Association conference this week in New Orleans.
"The key issue here is not only, 'Can we operate and are they alive?' but 'How are they doing?'" said Kurlansky, research director at the Florida Heart Research Institute.
Overall, 90 percent survived their surgery to leave the hospital. This improved dramatically as the study went on, from 85 percent in the early years to 98 percent by its end.
Additionally, 65 percent survived without surgery-related complications and even more without long-term complications.
Kurlansky said this was a "very, very remarkable" result. Patients also reported a quality of life similar to others their age who did not have bypass surgery.
In a separate study, researchers in Maine, New Hampshire and Vermont studied 8,796 patients with leaky aortic valves.
Surgery for these patients sometimes also included a bypass procedure.
Most were still alive six years after the surgery. Median survival was seven years - about the same as the general population of that age.
Earlier research found that people 76 and older recovered more slowly than younger patients after bypass surgery, but a year later most of them reported improvements in pain relief and quality of life similar to those for younger patients.
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Source: redorbti Staff & Wire Reports
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