Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
The Effects of Aging on Heart Surgery
share announcement

The Effects of Aging on Heart Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 5131

Special Issue Editor

Prof. Dr. Johannes Maximilian Albes

E-Mail Website
Guest Editor
Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
Interests: minimally invasive cardiac surgery; aortic and mitral valve repair; aortic surgery; endovascular prosthesis; cerebral protection; frailty; re-do procedures; new biomaterials for valves and vessels; myocardial function
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues

Demographic change has led to a steady increase in elderly and multimorbid patients. Many of them suffer from cardiovascular diseases that require sound treatment strategies, i.e., a reduction in the surgical burden to reduce risks. Minimally invasive surgical procedures and catheter-based interventions have already shown the desired results in terms of improved initial survival. However, many of these established strategies, such as TAVI, MitraClip, or PTCA, come at a cost. Re-hospitalizations and inadequate procedural success may limit the medium- and long-term desired effects such as reduction in re-hospitalizations, preservation of mobility, and quality of life. While there is absolutely no dispute that age alone is a useful predictor of outcome, it is not at all clear how to assess the extent of frailty. Any physician will immediately recognize a frail person, but despite all the frailty scores currently in use, there is a lack of reliable parameters to provide a predictor for estimating the outcome. Moreover, there is virtually no systematic treatment to reduce frailty, let alone interventions to address frailty.

It is time to consider old age and frailty not as such, but as conditions that can be assessed with reasonable accuracy and that can also be treated preoperatively or postoperatively or postinterventionally to improve the patient's condition so that they can live at home one year after surgery, require little nursing assistance, and have a good quality of life without requiring another hospitalization.

Thus, five goals can be specified:

  1. Are there any novel therapeutic strategies, implants, or techniques to reduce the surgical burden in elderly and frail patients?
  2. How can frailty be quantified and translated into a reliable predictor of outcome?
  3. How can such predictors be used to stratify between surgical, interventional, or hybrid procedures for the best outcome for the patient?
  4. Are there treatment options to reduce the extent of frailty before surgery or intervention?
  5. Are there specific frailty management options to improve outcomes after surgical or interventional procedures?

Manuscripts addressing these topics are therefore welcome for this Special Issue. The time for shrugging shoulders in the management of aging patients is over; the time is ripe for clear strategies to define, assess, stratify, and treat the aging patient.

Prof. Dr. Johannes Maximilian Albes
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac surgery
  • vascular surgery
  • minimally invasive cardiac surgery
  • minimally invasive vascular surgery
  • aging
  • frailty
  • cardiovascular prostheses
  • endovascular therapies
  • hybrid procedures
  • outcome predictors

Published Papers (5 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Editorial

Jump to: Research

5 pages, 441 KiB  
Editorial
The Best Way to Deal Is with Cold Steel…Is It?—Ways of Dealing with Age and Ageing in Cardiac Surgery
by Johannes M. Albes
J. Clin. Med. 2022, 11(23), 7116; https://doi.org/10.3390/jcm11237116 - 30 Nov 2022
Viewed by 974
Abstract
Everyone knows from their own experience what ageing means [...] Full article
(This article belongs to the Special Issue The Effects of Aging on Heart Surgery)
►▼ Show Figures

Figure 1

Research

Jump to: Editorial

14 pages, 2037 KiB  
Article
Clinical Outcomes after Multivalve Surgery in Octogenarians: Evaluating the Need for a Paradigm Shift
by Ali Taghizadeh-Waghefi, Asen Petrov, Sebastian Arzt, Konstantin Alexiou, Sems-Malte Tugtekin, Klaus Matschke, Utz Kappert and Manuel Wilbring
J. Clin. Med. 2024, 13(3), 745; https://doi.org/10.3390/jcm13030745 - 27 Jan 2024
Viewed by 805
Abstract
(1) Background: this study addresses the lack of comprehensive research on outcomes in octogenarians undergoing cardiac surgery for multivalvular disease, emphasizing the need for a critical examination of the intervention’s overall worth in this aging population. (2) Methods: By analyzing short-term and mid-term [...] Read more.
(1) Background: this study addresses the lack of comprehensive research on outcomes in octogenarians undergoing cardiac surgery for multivalvular disease, emphasizing the need for a critical examination of the intervention’s overall worth in this aging population. (2) Methods: By analyzing short-term and mid-term data from 101 consecutive octogenarian patients undergoing multivalve surgery, the study identifies predictors for in-hospital and one-year mortality. (3) Results: In-hospital mortality increased fourfold with the occurrence of at least one postoperative complication. Octogenarians undergoing multivalve surgery experienced an in-hospital mortality rate of 13.9% and an overall one-year mortality rate of 43.8%. Postoperative delirium was identified as an independent risk factor, contributing to elevated risks of both in-hospital and one-year mortality. Prolonged surgical procedure time emerged as an independent risk factor associated with increased in-hospital mortality. Continuous veno-venous hemodialysis showed an independent impact on in-hospital mortality. Both re-intubation and the transfusion of packed red blood cells were identified as independent risk factors for one-year mortality. (4) Conclusions: This study urges a critical examination of the justification for multivalve surgeries in high-risk elderly patients, emphasizing a paradigm shift. It advocates for interdisciplinary collaboration and innovative strategies, such as staged hybrid procedures, to improve therapeutic approaches for this challenging patient group to achieve a better therapeutic outcome for these patients. Full article
(This article belongs to the Special Issue The Effects of Aging on Heart Surgery)
►▼ Show Figures

Figure 1

9 pages, 519 KiB  
Article
Living Longer or Better—Patient’s Choice in Cardiac Surgery Is Gender-Dependent—A Multicenter Study
by Britt Hofmann, Epp Rae, Ulrike Puvogel, Mihaela Spatarelu, Salah A. Mohamed, Almoan Bungaran, Sebastian Arzt, Magdalena L. Laux, Klaus Matschke, Richard Feyrer, Hans-Hinrich Sievers, Ivar Friedrich, Bernd Niemann, Rolf-Edgar Silber, Andreas Wienke and Andreas Simm
J. Clin. Med. 2023, 12(24), 7596; https://doi.org/10.3390/jcm12247596 - 9 Dec 2023
Viewed by 807
Abstract
In view of the increasing age of cardiac surgery patients, questions arise about the expected postoperative quality of life and the hoped-for prolonged life expectancy. Little is known so far about how these, respectively, are weighted by the patients concerned. This study aims [...] Read more.
In view of the increasing age of cardiac surgery patients, questions arise about the expected postoperative quality of life and the hoped-for prolonged life expectancy. Little is known so far about how these, respectively, are weighted by the patients concerned. This study aims to obtain information on the patients’ preferences. Between 2015 and 2017, data were analyzed from 1349 consecutive patients undergoing cardiac surgery at seven heart centers in Germany. Baseline data regarding the patient’s situation as well as a questionnaire regarding quality of life versus lifespan were taken preoperatively. Patients were divided by age into four groups: below 60, 60–70, 70–80, and above 80 years. As a result, when asked to decide between quality of life and length of life, about 60% of the male patients opted for quality of life, independent of their age. On the other hand, female patients’ preference for quality of life increased significantly with age, from 51% in the group below sixty to 76% in the group above eighty years. This finding suggests that female patients adapt their preferences with age, whereas male patients do not. This should impact further the treatment decisions of elderly patients in cardiac surgery within a shared decision-making process. Full article
(This article belongs to the Special Issue The Effects of Aging on Heart Surgery)
►▼ Show Figures

Figure 1

17 pages, 2609 KiB  
Article
Impact of Age on Endothelial Function of Saphenous Vein Grafts in Coronary Artery Bypass Grafting
by Lars Saemann, Lena Wernstedt, Sabine Pohl, Markus Stiller, Jan Willsch, Britt Hofmann, Gábor Veres, Andreas Simm and Gábor Szabó
J. Clin. Med. 2023, 12(17), 5454; https://doi.org/10.3390/jcm12175454 - 22 Aug 2023
Viewed by 914
Abstract
Background: An intact and functionally preserved endothelial layer in the graft is crucial for myocardial perfusion and graft patency after coronary artery bypass grafting (CABG). We hypothesized that old age is a risk factor for decreased endothelial function of bypass grafts. Thus, we [...] Read more.
Background: An intact and functionally preserved endothelial layer in the graft is crucial for myocardial perfusion and graft patency after coronary artery bypass grafting (CABG). We hypothesized that old age is a risk factor for decreased endothelial function of bypass grafts. Thus, we investigated the impact of age in patients treated with CABG on endothelial function in saphenous vein grafts. Methods: We mounted the saphenous vein graft segments of CABG patients < 70 (n = 33) and ≥70 (n = 40) years of age in organ bath chambers and exposed them to potassium chloride (KCl) and phenylephrine (PE) to test the receptor-independent and -dependent contractility, followed by exposure to acetylcholine (ACh) and sodium nitroprusside (SNP) to test the endothelial-dependent and -independent relaxation. Results: The maximal contraction induced by KCl (2.3 ± 1.8 vs. 1.8 ± 2 g) was stronger in patients ≥ 70 years of age. The relative contraction induced by PE in % of KCl (167 ± 64 vs. 163 ± 59%) was similar between groups. Patients aged < 70 years showed a higher endothelial-dependent relaxation induced by acetylcholine than patients ≥ 70 years (51 ± 27 vs. 42 ± 18%). The relaxation induced by SNP was similar between both groups. Conclusions: The endothelial function of saphenous vein bypass grafts decreases during aging. Thus, age should be considered when improving graft maintenance. Full article
(This article belongs to the Special Issue The Effects of Aging on Heart Surgery)
►▼ Show Figures

Figure 1

9 pages, 695 KiB  
Article
What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?
by Roya Ostovar, Filip Schröter, Ralf-Uwe Kühnel, Martin Hartrumpf and Johannes Maximilian Albes
J. Clin. Med. 2022, 11(23), 6907; https://doi.org/10.3390/jcm11236907 - 23 Nov 2022
Cited by 3 | Viewed by 1059
Abstract
Objective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of postoperative complications influencing [...] Read more.
Objective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of postoperative complications influencing outcomes in a challenging cohort of patients undergoing mitral valve surgery. Methods: The study enrolled 1627 patients who underwent mitral valve surgery. Patients younger than 40 years who had been diagnosed with endocarditis were excluded. Patients were divided into three groups with ages ranging from 40–59 (n = 319), 60–74 (n = 795), and >75 years (n = 513). Baseline, comorbidities, postoperative complications, and mortality were recorded. Results: The older the patients were, the more frequently they suffered from pre- and postoperative renal insufficiency (p < 0.001). The likelihood of postoperative renal failure requiring dialysis was significantly higher with pre-existing renal failure. There was a significant association between postoperative renal insufficiency and the development of postoperative pleural or pericardial effusion (p < 0.001, p = 0.016). A significant decrease in BMI was observed in patients >75 years of age compared to the 60–74 years group (27.3 vs. 28.2 kg/m2, p = 0.007). The development of critical illnesses such as myopathy and neuropathy (CIP/CIM) was age-dependent and increased significantly with age (p = 0.04). Hospitalization duration and mortality also increased significantly with age (p = 0.013, p < 0.001). Conclusions: It appears that elderly patients with advanced renal failure have a significantly higher risk of mortality, postoperative renal failure, need for dialysis, and possibly the development of pleural and pericardial effusions in mitral valve surgery. In addition, more frequent CIP/CIM with concomitant decrease in BMI in the most advanced age group indicate sarcopenia and thus an additional feature of frailty besides renal failure. Full article
(This article belongs to the Special Issue The Effects of Aging on Heart Surgery)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-5
Back to TopTop