[Cardiovascular Surgery in Nonagenarian]

Abstract

Objective: The number of nonagenarians who are eligible for surgery is increasing in Japan with the increase of the elderly population and the improvement of outcomes of cardiovascular surgery.

Methods: Six nonagenarians underwent cardiovascular surgery from January 2014 to December 2022. Frailty, activity of daily living, and postoperative survival were examined.

Results: The mean age was 90.8 (90-92) years old. Seven operations (2 coronary artery bypass, 3 cardiac valve surgery, and 2 ascending aorta replacement) were performed in 6 patients( 2 males and 4 females). Four of them were emergent or urgent surgery. The mean hospital stay was 39.0 days, without postoperative 30-day or in-hospital deaths. However, two patients died of aspiration pneumonia and cancer. Although early postoperative activities of daily living( ADL) was declined, ADL was improved to the same level as preoperative status, one year after operation. The mean postoperative observation period was 988.3 days, and the longest postoperative survival was 2,676 days.

Conclusion: Nonagenarians may have acceptable outcomes with cardiovascular surgery by evaluating not only age but also ADL and frailty.