[The aged heart in surgery].
The risk of surgical operation is increased by the presence of heart disease. The statistics are too limited for this risk to be expressed more precisely. The heart in the elderly is no longer a normal heart. The myocardial functional reserve declines, the quality of the A.V. conduction is not always good and vascular fibrosis progresses. Surgical operation thus increases the risk of a cardio-vascular accident. One should distinguish the risk due simply to old age. The existence of known heart disease often leads to heart failure which is difficult to treat. The great risk of surgical operation is then the risk of overloading the heart. In the absence of known heart disease, one should beware of latent coronary insufficiency. The major risk is then hypoxia. The special problem of degenerative A.V. conduction disorders may require the insertion of a pace-maker. Pre-opératoire cardio-vascular assessment is thus necessary in the elderly subject. It should, however, remain simple. Careful history and auscultation, verification of the periphéral arteries, chest XRay and E.C.G.
[The aged heart in surgery]. The risk of surgical operation is increased by the presence of heart disease. The statistics are too limited for this risk to be expressed more precisely. The heart in the elderly is no longer a normal heart. The myocardial functional reserve declines, the quality of the A.V. conduction is not always good and vascular fibrosis progresses. Surgical operation thus increases the risk of a cardio-vascular accident. One should distinguish the risk due simply to old age. The existence of known heart disease often leads to heart failure which is difficult to treat. The great risk of surgical operation is then the risk of overloading the heart. In the absence of known heart disease, one should beware of latent coronary insufficiency. The major risk is then hypoxia. The special problem of degenerative A.V. conduction disorders may require the insertion of a pace-maker. Pre-opératoire cardio-vascular assessment is thus necessary in the elderly subject. It should, however, remain simple. Careful history and auscultation, verification of the periphéral arteries, chest XRay and E.C.G.