The Importance of the “Closed” Method of Heart Surgery in Elderly Patients

When deciding on heart surgery in our patients of advanced age, we assess the resilience to surgery not only of the heart but of the whole body. In this article I will explain why the small-incision (closed) method is particularly valuable in elderly patients.

Bone Loss and Incision Healing in the Advanced Age Group

With advancing age, bone density decreases (osteoporosis); in classic surgery, where the breastbone is cut and joined together with wires, this may slow the process of bone healing and increase the risk of bone-related complications. Since the breastbone is not touched at all in small-incision techniques, this risk is eliminated.

How the Minimally Invasive Method Reduces Trauma in Elderly Patients

In our elderly patients, reduced surgical trauma directly affects not only wound healing but the whole recovery process; less pain, earlier mobilisation and a shorter stay in intensive care make an important difference, especially in patients with a high degree of frailty. For this reason we give priority to the small-incision method in our elderly patients whose anatomy is suitable.

Heart Surgery in Patients Over 80

Studies carried out in patients over 80 (octogenarians) show that with careful patient selection small-incision valve operations can be performed safely in this age group as well, and that the results can be more favourable than general expectations. Of course, in this age group careful assessment of additional illnesses and of general frailty is the most important part of the decision to operate.

Frequently Asked Questions

Is it safe to have heart surgery over the age of 80? With the right patient selection, yes; age alone is not an obstacle, and the real determining factors are general state of health and organ function.

Which method is preferred in elderly patients? If the anatomy is suitable, we give priority to the small-incision method because it involves less trauma.

Why is assessment of frailty important? Frailty is an important factor that affects surgical risk and the recovery process independently of age; it is therefore part of our preoperative assessment.

Conclusion

By reducing surgical trauma, the small-incision method can offer a safer and faster recovery process in our patients of advanced age. The decision is made by assessing general state of health and anatomical suitability together, rather than age itself.

If you have a heart valve problem at an advanced age, you can make an appointment so that we can assess the surgical method suitable for you.

References

1. Cammertoni F, Bruno P, Rosenhek R, et al. Minimally Invasive Aortic Valve Surgery in Octogenarians: Reliable Option or Fallback Solution? Innovations (Phila). 2021;16(2):126-133.
2. Seeburger J, Borger MA, Falk V, et al. Minimally-Invasive Mitral Valve Surgery in Octogenarians: A Brief Report. Ann Cardiothorac Surg. 2013;2(6):864-866.