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Elderly and High Risk
Our expert NYU cardiac surgeons have extensive experience in providing personalized treatment for patients from the age of 2 days to 98 years old and offer the best possible quality outcomes to the high risk patient. Our goal is to provide continuous, coordinated care, starting with the initial visit and extending through your stay in the hospital to your rehabilitation and discharge. We strive to keep patients and families fully informed and involved in the plan of care. We are always available to address your questions and concerns, a responsibility the cardiac surgeons share with the nurse practitioners.
There is no specific clinical marker for the ‘elderly' patient. People are living longer, well into their 80s and 90s, and they are much more likely to perform activities of daily living on their own and function independently. It is a false assumption that the elderly patient is destined to a steady decline after heart surgery. The elderly segment of the population is increasing rapidly and an increasing number of patients over 70 years old are undergoing heart surgery with improved outcomes. Although advanced age can be considered a risk factor, age alone should not be a reason to exclude patients from heart surgery.
NYU has published numerous research articles on short and long term outcomes in elderly and high risk patients undergoing heart surgery. One of the largest samples with minimally invasive surgery was reported from NYU where the vast majority of patients undergoing aortic valve surgery were more than 70 years of age and the avoidance of a traditional ‘open heart' sternotomy incision was especially advantageous. Osteoporosis, the loss of bone strength, can impair healing of the sternotomy. When outcomes of the traditional ‘open heart' sternotomy and the minimally invasive approach were compared for mitral valve repair, follow up results also demonstrated a marked advantage in the elderly patient. NYU research has shown that many elderly patients facing heart surgery can anticipate an improved quality of life, not a slower decline in activity. Minimally invasive heart surgery can help quicken the recovery process by performing this breast bone -sparing technique.
Our cardiac surgery team at NYU also specializes in the surgical care of high risk patients. A patient can be considered high risk if their history includes multiple additional risk factors, an acute episode of cardiac dysfunction, re-operative heart surgery, or severely advanced heart failure. Many high risk patients have structural heart defects that can be repaired with surgery, often with tremendous improvements in cardiac function and quality of life.
Only a comprehensive multidisciplinary approach such as ours can help determine which patients would benefit from surgery. The NYU Cardiac Surgery team includes specialists in cardiology, cardiac imaging, electrophysiology, psychiatry, social work, nutrition, and cardiac rehabilitation. The first step in our approach is to evaluate the patient's heart function and assess the need for early hospital admission to the intensive care unit with the goal of optimizing preoperative heart function. Next the team evaluates each individual case and discusses the various treatment options for each individual high risk patient.
Surgical procedures for high risk patients include, but are not limited to, coronary revascularization for severe left main disease, heart valve repair or replacement, surgical ventricular restoration, ventricular assist device implantations, and thoracic aortic dissection repair.