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J Thorac Cardiovasc Surg 2006;132:1226-1228
© 2006 The American Association for Thoracic Surgery

Brief Communication

Against the odds: Long-term outcome of drastic-risk cardiac surgery

Serban Stoica, AFRCS, Hiremagalur Balaji, MRCS, Adel Helmy, MRCS, Jago Kitcat, BA, Carol Freeman, MSc, Linda Sharples, PhD, Samer A.M. Nashef, FRCS*

Papworth Hospital, Cambridge, United Kingdom.

Received for publication June 14, 2006; accepted for publication June 28, 2006.

* Address for reprints: Samer A. N. Nashef, FRCS, Consultant Cardiothoracic Surgeon, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE, UK. (Email: Sam.Nashef@papworth.nhs.uk).

The first 20% of the full text of this article appears below.

An average early mortality in low, single-percentage figures is now the norm in most cardiac surgical centers. Nevertheless, the spectrum of risk for individual patients is wide, and there are times when surgeons are called on to perform operations in patients in a precarious situation, for example, with associated comorbidity, an inherent risk of complex surgery, or, commonly, both. Risk-assessment models can help identify high-risk patients who require cardiac surgery. Some studies report good results for patients who have a protracted stay in the intensive care unit because of perioperative problems, but the majority of such patients have an acceptable risk to start with. Little is known about the long-term outcomes of drastic-risk cardiac surgery. Are such high-risk, resource-intensive interventions worthwhile?

We sought to determine late survival and quality of life (QOL) in patients undergoing cardiac surgery with a predicted risk of death greater . . . [Full Text of this Article]




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