Dimitrios Protogeros
Cardiac Surgeon, Greece
Title: The evolution of cardiovascular surgery in elderly patients: Science and technology contribution
Biography
Biography: Dimitrios Protogeros
Abstract
Due to the increase of average life expectancy and the higher incidence rate of cardiovascular disease with advancing age, more elderly patients are in need of cardiac surgery nowadays. Advances in pre- and post-operative care have made it possible that an increasing number of elderly patients can be operated safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is acceptable, only in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease, and poor clinical state are associated with a worse outcome in elderly patients. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia, and adequate myocardial protection are basic requirements for the success of cardiac surgery in elderly patients. The care of elderly cardiac surgical patients can be improved only through the strict collaboration of geriatricians, anesthesiologists, cardiologists, and cardiac surgeons, in order to obtain a tailored treatment for each individual patient.
We describe a combined cardiac surgery procedure , aortic valve replacement and double coronary bypass, on a 91-year old lady with hypertension, diabetes mellitus, renal insufficiency and cerebrovascular disease known as the oldest patient worldwide who has undergone this type of procedure.