• Frédéric Collart, Horea Feier, Francois Kerbaul, Annick Mouly-Bandini, Alberto Riberi, Thierry G Mesana, and Dominique Metras.
• Service de Chirurgie cardiaque, Hopital de la Timone, 246 rue St Pierre, 13385 Marseille cx 05, France. fcollart@univ-aix.fr
• Eur J Cardiothorac Surg. 2005 Feb 1; 27 (2): 276-80.

ObjectivesIn the last decade, cardiac surgery in octogenarians is becoming a routinely performed procedure in our Western countries. The functional benefit of this surgery had already been proved. The aim of this study was to evaluate operative mortality, to identify pre- and post-operative risk factors of early and late mortality, to assess the Euroscore count in this high-risk group of patient and to evaluate late results of this surgery.MethodsWe reviewed 215 consecutive patients with a mean age of 83+/-2 years having undergone valvular surgery. There were 127 female patients (57.1%) and 88 males (42.9%). One hundred and fifty-nine patients (74%) underwent aortic valve replacement 42 (19.5%) mitral surgery and 14 (6.5%) double valve surgery. There were 32 (14.9%) re-operative cases. Twenty-seven patients (12.6%) were operated on in emergency. There were 32 re-operations (14%). The EuroSCORE was used to assess predicted operative risk. Mean Euroscore additive count was 9.5+/-2.3 and mean logistic Euroscore was 15.1%.ResultsOperative mortality was 8.8% (19 patients). Left ventricular dysfunction was the only pre-operative significant risk factors of mortality (P=0.05). Low cardiac output (P<0.001), gastrointestinal complications (P=0.03) and surgical reexploration (P=0.001) were significant risk factors of mortality. Mean survival was 84% after one year and 56% after 5 years.ConclusionsValvular surgery in octogenarians is a safe and low risk procedure compared to functional benefit and long-term survival. Our data how that logistic Euroscore overestimates the mortality in this high-risk group of patients.

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