Cardiac surgery in the present age - How old is too old

摘要

In the article entitled 'Aortic valve replacement with and without coronary artery bypass graft surgery in octogenarians: is it safe and feasible?' published in this issue of Cardiology [1], the investigators have demonstrated that an elderly patient population (80+ years old) can successfully undergo surgical aortic valve replacement (AVR) and AVR/coronary artery bypass grafting (CABG) with acceptable morbidity and mortality. As stated by the US Census Bureau, average life expectancy in the USA will reach 81.4 years of age by the year 2015. With the advancing age of the baby boomers, better medical care and better life expectancy with chronic medical conditions, this will be a situation that many of us will continue to face. How old is too old? This is a question yet to be answered practically, economically and ethically. With the advancement of technology, less and less invasive procedures are routinely being performed, and with a more sophisticated multidisciplinary approach to postoperative care, the results of surgery in the elderly will continue to improve and case volume will not only grow, but will eventually be the norm.