Abstract
Preoperative assessment of cardiovascular complications was analyzed in relation to postoperative course of 89 elderly (over 70 years) patients with pulmonary diseases surgically treated at our department between January 1980 and December 1989 (76 cases of lung cancer and 13 cases of benign pulmonary diseases). Before operation, 33 patients (37%) had cardiovascular complications, and 47 (57%) had electrocardiographic abnormalities (including 31 with ischemic ECG abnormalities). Preoperative coronary angiography for assessment of ischemic heart diseases was performed in 5 patients (including those in whom operation could not be successfully performed). In 2 of these 5 patients, lobectomy was performed after PTCA. Postoperative cardiovascular complications observed included hypertension (35 cases), arrhythmias (22 cases) and cardiac failure (5 cases). No patients had postoperative myocardial infarction or died of cardiovascular complications in the early postoperative stage or during hospitalization. These results suggest a high incidence of postoperative complications in elderly patients even when their preoperative assessment discloses no cardiovascular abnormalities. This indicates that preoperative cardiovascular complications in elderly with pulmonary diseases tend to be latent. However, if pre-, intra- and postoperative assessment an management are carefully performed, it may be possible to widen the indications of pulmonary operation in elderly patients, and serious cardiovascular complications may be mostly avoidable or controllable.
