초록접수 현황
| 16F-103 | 포스터 발표 |
How Old is too Old for Life Saving Heart Surgery? (Ascending and Hemiarch Replacement in 97 Year old Patient)
Hyung Chae Lee¹, Ji Ha Lee¹, Sun Jin Joo¹, Jing Hong Wi²
¹Department of Thoracic and Cardiovascular Surgery, Dongkang Medical Center, Ulsan, Korea, ²Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan Korea
Background : There has been an increase in the number of elderly patients considered for cardiac surgery. Several reports have documented acceptable morbidity and mortality in patients 80 years and older. However, literature consists of only seldom reports of aortic surgery due to ruptured aortic aneurysm in patients above 90 years of age.
Methods : A 97-year-old female patient, who has a known HTN, DM for almost 30 years, was diagnosed to ruptured ascending aortic aneurysm with pericarial tamponade. We decided to perform surgery for the patient. Cardiopulmonary bypass was achieved with right axillary artery and right atrial standard “two-stage” venous cannulation. We started to cool down the temperature of the patient to 28°C. After resection of ascending aorta, distal anastomosis was performed by open technique. Seclective cerebral perfusion time was 55min and total bypass time was 225min. The operation was finished by classical method and the patient was taken to the ICU.
Results : The patient was discharged the hospital on the 18th day postoperatively without events. It was found that the patient have had no problem until 6month after discharge.
Conclusion : Some report of acceptable marbidity and mortality after open heart surgey in patient of very old age. But almost of the report was patient performed elective heart surgery. In the case of emergent case, we can have questions like "what should heart surgeons do for very old patient? How old is too old for life saving surgery?". The biggest change in the last decade is that there are no limits. There's nothing we can’t do for an old person, and there’s a lot of pressure to do it.
Methods : A 97-year-old female patient, who has a known HTN, DM for almost 30 years, was diagnosed to ruptured ascending aortic aneurysm with pericarial tamponade. We decided to perform surgery for the patient. Cardiopulmonary bypass was achieved with right axillary artery and right atrial standard “two-stage” venous cannulation. We started to cool down the temperature of the patient to 28°C. After resection of ascending aorta, distal anastomosis was performed by open technique. Seclective cerebral perfusion time was 55min and total bypass time was 225min. The operation was finished by classical method and the patient was taken to the ICU.
Results : The patient was discharged the hospital on the 18th day postoperatively without events. It was found that the patient have had no problem until 6month after discharge.
Conclusion : Some report of acceptable marbidity and mortality after open heart surgey in patient of very old age. But almost of the report was patient performed elective heart surgery. In the case of emergent case, we can have questions like "what should heart surgeons do for very old patient? How old is too old for life saving surgery?". The biggest change in the last decade is that there are no limits. There's nothing we can’t do for an old person, and there’s a lot of pressure to do it.
책임저자: Hyung Chae Lee
Department of Thoracic and Cardiovascular Surgery, Dongkang Medical Center, Ulsan, Korea
발표자: Hyung Chae Lee, E-mail : cvsdoc@gmail.com