Minimally Invasive Surgery for Octogenarians: Is It a Contraindication or a Prejudice?
Elisa Mikus, Simone Calvi, Carlotta Brega, Alberto Tripodi, Fabio Zucchetta, Alberto Albertini
Maria Cecilia Hospital, GVM for Care & Research, Cotignola (Ra), Italy
BACKGROUND: Nowadays, indication for cardiac surgery in octogenarians has increased, as a result of longer life expectancy. In the meantime, use of minimally invasive techniques is expanding. The aim of the study is to investigate the role of minimally invasive surgery in aging population.
METHODS: Between January 2010 and August 2019, 1674 octogenarian patients underwent cardiac surgery at Maria Cecilia Hospital. This retrospective observational study focused on 854 of them treated for isolated aortic or mitral valve disease though minimally invasive approaches or standard full sternotomy. RESULTS: Patients were treated mainly for aortic disease (n= 716; 84%), in an inferior percentage for mitral disease (n=138; 16%). Minimally invasive approach, preferred in 573 patients, included: right mini-thoracotomy (44%) and aortic valve, upper ministernotomy (56%). All In the minimally invasive group no death occurred in the operating room and in hospital mortality was 3.5%, comparable results were found in the traditional group treated with full sternotomy (3.6%). Seven years follow-up was counted from date of diagnosis to end of follow-up showing no difference in survival using both techniques (p=0.24). CONCLUSIONS: we report a significant case series of minimally invasive cardiac surgery in octogenarians. Results in minimally invasive groups are not inferior to those obtained with traditional full sternotomy, or rather, slightly better. Age is not a contraindication for minimally invasive approaches.