The hidden consequences of the changing cardiac surgical population

Excerpt

The characteristics of adults presenting for cardiac surgery have changed dramatically over the last 20 years. With rising life expectancy, these individuals are now older, frailer, and burdened with chronic illness.1,2 Furthermore, advancements in interventional cardiology and percutaneous interventions have meant that open cardiac surgical procedures increasingly consist of higher-risk procedures, such as multi-valve or aortic replacement procedures.1,2 Although improvements in perioperative care have kept the overall mortality risk low (1-3%) among cardiac surgical patients, a subgroup still experiences complicated protracted postoperative recoveries that are associated with longer hospitalizations and elevated risks of short- and long-term mortality. In this issue of the Journal, McIsaac et al. present a population-based cohort study of adult cardiac surgical patients that provides important new data to inform our understanding of this problem.3 …