[HSF] Nonagenarians and Cardiac Surgery

[Nasser F. Abou'Seada]

> Age is a number to be considered, but I
> > feel obligated to evaluate the patient's cormorbidites, mental
> > acuity, mental outlook, etc, before categorically denying a patient
> > surgery just because they are in their 90's.< 

Certainly Sounds Logic .... totally agree ........ though having no such
patient in such age group ... 

NFA
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Edward Bender
> Sent: Friday, November 17, 2006 7:20 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Nonagenarians and Cardiac Surgery
> 
> I remember a 92 year old with disabling angina I did a CABG on a
> couple of years ago.  Discharged on post-op day 4, and then he went
> to Las Vegas to help set up an amusement park type train for a couple
> of the casinos.  There are 90 year olds and then there are 90 year
> olds.  Generalizations don't equate to universality.
> 
> Ed Bender, MD
> 
> 
> On Nov 17, 2006, at 2:25 PM, hgrmd at aol.com wrote:
> 
> > Tomas,
> >   I've done several patients in their 90's in my career.  Most of
> > them did reasonably and sometimes surprisingly well.  The key is
> > selection.  I generally won't operate on your average patient in
> > their 90's, but there are worthy exceptions.  Heck, I've turned
> > down some patients in their 30's or 40's because the cormorbidities
> > and the heart were so bad.  Age is a number to be considered, but I
> > feel obligated to evaluate the patient's cormorbidites, mental
> > acuity, mental outlook, etc, before categorically denying a patient
> > surgery just because they are in their 90's.  An example was the
> > sharp 93 yo grandmother of an internist who kept being admitted for
> > chest pain from severe 3vd.  I did her CABG, she did well, and was
> > living an active life at least 4 years later.  I'm sure plenty of
> > other members of HSF can relate similar experiences.
> > Hal
> >
> >
> > -----Original Message-----
> > From: TSalerno at med.miami.edu
> > To: OpenHeart-L at lists.hsforum.com
> > Sent: Fri, 17 Nov 2006 2:08 PM
> > Subject: RE: [HSF] Factor VII
> >
> >
> > Should a 90 year old be subjected to heart surgery? Anyone has seen
> > his/her grandmother at that age, and what she looks like?
> >
> > Tomas
> >
> > -----Original Message-----
> > From: openheart-l-bounces at lists.hsforum.com
> > [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Ben
> > Bidstrup
> > Sent: Friday, November 17, 2006 1:49 PM
> > To: OpenHeart-L at lists.hsforum.com
> > Subject: Re: [HSF] Factor VII
> >
> >> Prasanna,
> >>   Basically, I wasn't thinking of the possible legal consequences
> >> when
> > I
> >> used VII, because I knew the potential for such was nil.  No South
> > Florida
> >> lawyer on contingency is going to take a case of a 90 yo cardiac
> >> surgical patient
> >> against a bare surgeon.  Now, if the patient had been in  her 50's
> >> with
> > a
> >> difficult family, then I might have had other thoughts.
> >> Hal
> >> _______________________________________________
> >
> > Hal,
> > I am sure very few of us in a situation like this think of anything
> > but the benefits for the patient. It is easy to be 'wise' after the
> > event and that is what we are able to do here.
> >
> > --
> > Ben Bidstrup FRACS FRCSEd FEBCTS
> > Consultant Cardiothoracic Surgeon
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