Surgery in the Aged

  • John L. Ochsner
  • James R. DouglasJr.
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 76)


Elderly is defined by Webster’s New Collegiate Dictionary as being “rather old, past middle age” [1]. This definition appears vague. Since there are really no means of measuring physiologic age, it is difficult to state what age signifies elderly. To add to the difficulty and confusion, particularly in regard to surgery, the definition of elderly varies from 45 years to greater than 80 years in different reports. However, most authorities today believe that people older than 65 years of age are elderly, since following this age there is a fairly rapid and constant decline in general health.


Valve Replacement Aortic Stenosis Aortic Valve Replacement Mitral Valve Replacement Extracorporeal Circulation 
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  1. 1.
    Webster’s New Collegiate Dictionary, 150th ed. Springfield, MA: G&C Merriam Co., 1981, p 362.Google Scholar
  2. 2.
    Goldman R. Decline in organ functioning with aging. In I Rossman (ed), Clinical Geriatrics, 2d ed. Philadelphia: Lippincott Co, 1979, pp 23–59.Google Scholar
  3. 3.
    Debakey ME and McCollum CH. Vascular grafts in the elderly. Med Instrum 16(2):89–90, 1982.PubMedGoogle Scholar
  4. 4.
    Harbrecht PJ, Garrison RN, and Fry DE. Surgery in elderly patients. South Med J 74(5):594–598, 1981.PubMedCrossRefGoogle Scholar
  5. 5.
    U.S. Dept. of Vital Statistics, Commerce Bureau of Census. Statistical Abstract of the United States, 91st Annual Edition. Washington, D.C.: U.S. Government Printing Office, 1970, Table 5–6, p 53.Google Scholar
  6. 6.
    United States Life Table. Vital Statistics of the United States, Vol. II, Section V: Life Tables, 1964, Table 4–5.Google Scholar
  7. 7.
    U.S. Dept. of Health, Education and Welfare. Vital Statistics of the United States, Vol. II, Part A: Mortality Analysis and Summary. USPHS, 1960, p 25.Google Scholar
  8. 8.
    U.S. Dept. of Health, Education and Welfare. Vital Statistics of the United States, Vol. II, Part B: Mortality Analysis and Summary. USPHS, 1960, p 12.Google Scholar
  9. 9.
    Goldstein S, Harley CB, and Moerman EJ. Some aspects of cellular aging. J Chron Dis 36:103–116, 1983.PubMedCrossRefGoogle Scholar
  10. 10.
    Cole WH. Medical differences between the young and the aged. J Amer Geriat Soc 18:589–614, 1970.Google Scholar
  11. 11.
    Djokovic JL and Hedley-Whyte J. Prediction of outcome of surgery and anesthesia in patients over 80. JAMA 242:2301–2306, 1979.PubMedCrossRefGoogle Scholar
  12. 12.
    Michel SL, Stevens L, Amodeo P, et al. Surgical procedures in nonagenarians. West J Med 141:61–63, 1984.PubMedGoogle Scholar
  13. 13.
    Greenburg AG, Salk RP, and Pridhan D. Influence of age on mortality of colon surgery. Am J Surg 150:65–70, 1985.PubMedCrossRefGoogle Scholar
  14. 14.
    Colapinto WD. Is age alone a contraindication to major cancer surgery? Can J Surg 29:323–326, 19.Google Scholar
  15. 15.
    Anderson B and Ostberg J. Long-term prognosis in geriatric surgery: 2–17 year follow-up of 7922 patients. J Amer Geriat Soc 20:255–257, 1972.Google Scholar
  16. 16.
    Tarhan S, Moffitt EA, Taylor WF, et al. Myocardial infarction after general anesthesia. JAMA 220:1451–1454, 1972.PubMedCrossRefGoogle Scholar
  17. 17.
    Steen PA, Tinker, JH, and Tarhan S. Myocardial reinfarction after anesthesia and surgery. JAMA 239:2566–2570, 1978.PubMedCrossRefGoogle Scholar
  18. 18.
    Tinker JH, Noback CR, Vlietstra RE, et al. Management of patients with heart disease for noncardiac surgery. JAMA 246:1348–1350, 1981.PubMedCrossRefGoogle Scholar
  19. 19.
    Topkins MJ and Artusio JF Jr. Myocardial infarction and surgery: A five year study. Anesth Analg 43(6):716–720, 1964.PubMedCrossRefGoogle Scholar
  20. 20.
    Raabe DS Jr. Management of unstable angina pectoris. Geriatrics 37(2):40–46, 1982.PubMedGoogle Scholar
  21. 21.
    Mahar LJ, Steen PA, Tinker JH, et al. Perioperative myocardial infarction in patients with coronary artery disease with and without aorto-coronary bypass grafts. J Thorac Cardiovasc Surg 76:533–537, 1978.PubMedGoogle Scholar
  22. 22.
    Fudge TL, McKinnon WM, Schoettle GP, et al. Improved operative risk after myocardial revascularization. So Med J 74(7):799–801, 1981.CrossRefGoogle Scholar
  23. 23.
    Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 297:845–850, 1977.PubMedCrossRefGoogle Scholar
  24. 24.
    Goldman L and Caldera DL. Risks of general anesthesia and elective operations in the hypertensive patient. Anesthesiology 50:285–292, 1979.PubMedCrossRefGoogle Scholar
  25. 25.
    Gerson MC, Hurst JM, Hertzberg VS, et al. Cardiac prognosis in noncardiac geriatric surgery. Ann Intern Med 103:832–837, 1985.PubMedCrossRefGoogle Scholar
  26. 26.
    Benhamou AC, Kieffer E, Tricot JF, et al. Carotid artery surgery in patients over 70 years of age. Int Surg 66(3):199–202, 1981.PubMedGoogle Scholar
  27. 27.
    Sheelhy TW. Preoperative examination in the elderly. Resident and staff Physician, (September): 63–67, 1979.Google Scholar
  28. 28.
    Reichle FA, Rankins KP, Tyson RR, et al. The elderly patient with severe arterial insufficiency of the lower extremity: Limb salvage by femoro-popliteal reconstruction. Circulation 60(2 Pt 2):124–126, 1979.PubMedCrossRefGoogle Scholar
  29. 29.
    Sourcebook on Aging. Chicago: Marquis Academic Media, Who’s Who Inc, 1977.Google Scholar
  30. 30.
    Salerno RA, Hermandez P, and Lynn RB. Abdominal aortic aneurysm in the elderly. Can J Surg 24(1):71–72, 1981.PubMedGoogle Scholar
  31. 31.
    Petracek MR, Lawson JD, Rhea WG Jr, et al. Resection of abdominal aortic aneurysms in the over 80 age group. South Med J 73(5):579–581, 1980.PubMedCrossRefGoogle Scholar
  32. 32.
    Bosman CH and Stubbe LT. Twenty years experience of surgical treatment of the ruptured atherosclerotic aneurysm of the abdominal aorta. Neth J Surg 33(4):160–164, 1981.PubMedGoogle Scholar
  33. 33.
    Lawrie GM, Morris GC Jr, Crawford ES, et al. Improved results of operation for ruptured abdominalaortic aneurysms. Surgery 85(5):483–488, 1979.PubMedGoogle Scholar
  34. 34.
    Hakki AH, Iskandrain AS, Segal BL, et al. What are the indications for a coronary bypass? Geriatrics 37(7):37–39, 1982.Google Scholar
  35. 35.
    Hochberg MS, Levine FH, Dassett WM, et al. Isolated coronary artery bypass grafting in patients seventy years of age and older: Early and late results. J Thorac Cardiovasc Surg 84(2):219–223, 1982.PubMedGoogle Scholar
  36. 36.
    Knapp WS, Douglas JS Jr, Craver JM, et al. Efficacy of coronary artery bypass grafting in elderly patients with coronary artery disease. Am J Card 47(4):923–930, 1981.PubMedCrossRefGoogle Scholar
  37. 37.
    Tucker BL, Lindesmith GG, Stiles QR, et al. Myocardial revascularization in patients 70 years of age and older. West J Med 126(3):179–183, 1977.PubMedGoogle Scholar
  38. 38.
    Jones TW, Thomas GI, Stavney LS, et al. Aortic valve replacement and the senior citizen. Am Surg 45(11):684–699, 1979.PubMedGoogle Scholar
  39. 39.
    Murphy ES, Lawson RM, Starr A, et al. Severe arotic stenosis in patients 60 years of age or older: Left ventricular function and 10 year survival after valve replacement. Circulation 64(2 Pt 2):184–188, 1981.Google Scholar
  40. 40.
    Jamieson WR, Dooner J, Munro AI, et al. Cardiac valve replacement in the elderly: A review of 320 consecutive cases. Circulation 64(2 pt 2):177–183, 1981.Google Scholar
  41. 41.
    Teply JF, Grunkemeier GL, and Starr A. Cardiac valve replacement in patients over 75 years of age. Thorac Cardiovasc Surg 29(1):47–50, 1981.PubMedCrossRefGoogle Scholar
  42. 42.
    Stephenson LW, MacVaugh H III, and Edmunds LH Jr. Surgery using cardiopulmonary bypass in the elderly. Circulation 58(2):250–254, 1978.PubMedCrossRefGoogle Scholar
  43. 43.
    Hochberg MS, Derkac WM, Conkel DM, et al. Mitral valve replacement in elderly patients: Encouraging postoperative clinical and hemodynamic results. J Thorac Cardiovasc Surg 77(3):422–426, 1979.PubMedGoogle Scholar
  44. 44.
    Berman ND, David TE, Lipton IH, et al. Surgical procedures involving cardiopulmonary bypass in patients age 70 or older. J Am Geriatri Soc 28(1):29–32, 1980.Google Scholar

Suggested Readings

  1. Bergdal L, Bjork VD, and Jonasson R. Aortic valve replacement in patients over 70 years. Scand J Thorac Cardiovas Surg 15(2):123–128, 1981.CrossRefGoogle Scholar
  2. Dalby AJ, Firth BG, and Forman R. Preoperative factors affecting the outcome of isolated mitral valve replacement: A 10 year review. Am J Cardiol 47(4):826–834, 1981.PubMedCrossRefGoogle Scholar
  3. Delin K, Aurell M, Granerus G, et al. Surgical treatment of renovascular hypertension in the elderly patient. Acta Med Scand 211(3):169–174, 1982.PubMedCrossRefGoogle Scholar
  4. Detsky AS, Abrams HB, Forbath W, et al. Cardiac assessment for patients undergoing noncardiac surgery. A multifactorial clinical risk index. Arch Intern Med 1:211–219, 1986.Google Scholar
  5. Glasser SP, Spoto ED Jr, Soloman DA, et al. When cardiac patient becomes surgical patient. Hospital Practice 14:165–173, 1979.PubMedGoogle Scholar
  6. Koch JP, Maron BJ, Epstein SE, et al. Results of operation for obstructive hypertrophic cardiomyopathy in the elderly. Septal myotomy and myectomy in 20 patients 65 years of age or older. Am J Cardiol 46(6):963–966, 1980.PubMedCrossRefGoogle Scholar
  7. National Halothane Study. U.S. Department of Health Education and Welfare, 1969.Google Scholar
  8. Ochsner JL and Mills NL: Coronary Artery Surgery. Philadelphia: Lea & Febiger, 1978.Google Scholar
  9. Storstein D and Efskind L. Aortic valve replacement in elderly patients. Acta Med Scand 206(3):161–164, 1979.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1987

Authors and Affiliations

  • John L. Ochsner
  • James R. DouglasJr.

There are no affiliations available

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