Surgical Coronary Revascularization in Geriatric Patients
Surgical Coronary Revascularization in Geriatric Patients
Surgical coronary revascularization, especially in geriatric patients, is technically demanding and requires careful patient selection, selection of type of procedure, and postoperative care. Recent advances in coronary revascularization, especially in the variety of minimally invasive approaches and beating heart surgery, has enabled surgeons to operate upon elderly patients with improved results.
"To be seventy years young is sometimes far more cheerful and hopeful than to be forty years old."
-- Oliver Wendell Holmes
Age is often a marker for comorbid illnesses that may complicate attempts at surgical intervention for coronary artery disease. Careful selection is important in deciding to recommend open heart surgery for geriatric patients, so that selected elderly patients may benefit from heart surgery. Ancillary services, such as nutrition, nursing, and physical therapy, are particularly important components in the postoperative care of geriatric patients. In general, advanced age is not a contraindication to heart surgery, but it reinforces the need for careful preoperative evaluation and vigorous postoperative support of the patient. Increased life expectancy in the United States has increased the number of geriatric patients likely to come to the surgeon's attention. Striking population growth is anticipated in future decades for the oldest -- the octogenarians and nonagenarians. Many geriatric patients can derive important benefits in both quality and quantity of life from surgical intervention, but careful patient selection and diligent preoperative and postoperative care are important to minimize the rate of surgical complications in this population.
Surgical coronary revascularization, especially in geriatric patients, is technically demanding and requires careful patient selection, selection of type of procedure, and postoperative care. Recent advances in coronary revascularization, especially in the variety of minimally invasive approaches and beating heart surgery, has enabled surgeons to operate upon elderly patients with improved results.
"To be seventy years young is sometimes far more cheerful and hopeful than to be forty years old."
-- Oliver Wendell Holmes
Age is often a marker for comorbid illnesses that may complicate attempts at surgical intervention for coronary artery disease. Careful selection is important in deciding to recommend open heart surgery for geriatric patients, so that selected elderly patients may benefit from heart surgery. Ancillary services, such as nutrition, nursing, and physical therapy, are particularly important components in the postoperative care of geriatric patients. In general, advanced age is not a contraindication to heart surgery, but it reinforces the need for careful preoperative evaluation and vigorous postoperative support of the patient. Increased life expectancy in the United States has increased the number of geriatric patients likely to come to the surgeon's attention. Striking population growth is anticipated in future decades for the oldest -- the octogenarians and nonagenarians. Many geriatric patients can derive important benefits in both quality and quantity of life from surgical intervention, but careful patient selection and diligent preoperative and postoperative care are important to minimize the rate of surgical complications in this population.
