Open-Heart Surgery in Patients Over Sixty Years of Age

One hundred five patients over sixty years of age underwent open-heart sur gery at Kagoshima University Hospital during the period 1978-1986. The over all operative mortality rate was 22.8% (early: 17.1%, late: 5.7%), much higher than that of 6.9% (early: 5.3%, late: 1.6%) in younger patients under sixty years of age who had this surgery during the same period. Those who under went valve replacements showed a particularly high mortality rate. The opera tive mortality was significantly influenced by such factors as preoperative degrees of heart failure according to the NYHA functional class, the incidence of postoperative complications, the duration of cardiopulmonary bypass proce dures, and the duration of ischemic arrest. Despite a high mortality rate in elderly patients, age per se should not be a contraindication since the majority of hospital survivors are active in their daily life and the operative mortality has been reduced every year.