Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942003000500012
Brazilian Journal of Anesthesiology
Clinical Information

Incidência de cirurgia cardíaca em octogenários: estudo retrospectivo

Incidence of cardiac surgery in octogenarian patients: retrospective study

Luciano Brandão Machado; Sílvia Chiaroni; Paulo Oliveira Vasconcelos Filho; José Otávio Costa Auler Júnior; Maria José Carvalho Carmona

http://dx.doi.org/10.1590/S0034-70942003000500012 Braz J Anesthesiol, vol.53, n5, p.646-653, 2003
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Resumo

JUSTIFICATIVA E OBJETIVOS: O aumento da expectativa de vida faz com que pacientes cada vez mais idosos tenham indicação de tratamento cirúrgico de cardiopatias. Este estudo tem como objetivo avaliar a incidência de pacientes com mais de 80 anos submetidos à cirurgia cardíaca no Instituto do Coração do Hospital das Clínicas da FMUSP, nos últimos 16 anos. MÉTODO: Foram analisados, no período de 1986 a 2001, o número de cirurgias de revascularização do miocárdio (RM) e cirurgia valvar (CV) e, em cada grupo, o número de cirurgias em pacientes com mais de 80 anos. Os dados foram analisados descritivamente. RESULTADOS: Os dados revelam aumento progressivo do número de octogenários submetidos à cirurgia cardíaca. As cirurgias de revascularização do miocárdio tiveram aumento de 0,13% em 1986 para 3,5% em 2001. As cirurgias valvares aumentaram de 0% em 1986 para 1,44% em 2001, registrando o maior valor de 3,02% em 1999. CONCLUSÕES: Os conhecimentos da fisiopatologia, da senilidade e os avanços no manuseio do trauma cirúrgico estão permitindo estender os recursos da cirurgia cardíaca no grupo de paciente mais idoso. A escolhas da técnica anestésica deve ser criteriosa, bem como a hidratação, a assistência ventilatória e a analgesia pós-operatória, permitindo redução da morbimortalidade neste grupo de maior risco cirúrgico.

Palavras-chave

CIRURGIA, CIRURGIA

Abstract

BACKGROUND AND OBJECTIVES: Increased life expectancy makes increasingly older patients to be submitted to cardiac surgeries. This study aimed at evaluating the incidence of octogenarian patients submitted to cardiac surgeries in the Heart Institute, Hospital das Clínicas, FMUSP, in the last 16 years. METHODS: The number of myocardial revascularization (MR) and valvar surgeries (VS) was analyzed for the period 1986 to 2001 and, within each group, the number of surgeries in octogenarian patients. Data were descriptively analyzed. RESULTS: Data have shown a progressive increase in the number of octogenarian patients submitted to cardiac surgeries. Myocardial revascularization surgeries have increased from 0.13% in 1986 to 3.5% in 2001. Valvar surgeries have increased from 0% in 1986 to 1.44% in 2001, with the highest rate of 3.02% in 1999. CONCLUSIONS: The understanding of pathophysiology and senility, and the advances in surgical trauma handling are allowing cardiac surgery resources to be expanded to elderly patients. Anesthetic technique should be carefully chosen, as well as hydration, ventilatory assistance and postoperative analgesia, to provide decreased morbidity and mortality in this higher surgical risk group.

Keywords

SURGERY, SURGERY

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