Should Grandma get with 91 a new heart valve? Doctors in Germany have answered such questions in the past few years, more and more often with Yes. The number of cardiac operations in patients over 80 has increased since the year 2000, the German heart report 2018, which was presented in Berlin. So much so, that this growth can be alone with the aging population does not explain.
It was in the year 2000 in Germany, around 4225 heart operations at the age of 80 Plus, the most recent figure for 2017 already 16.242.
Critics ask, given the Numbers whether or not hospitals make money with operations, the old people might not need. Dietrich Andresen, Chairman of the German heart Foundation, can understand such questions. It was something that, in Germany, beyond 80 for example, more pacemakers and Stents would be used than in other European countries. “But it is not the surgery too much,” he said.
A significant impact on the growing operation in the age of progress in anesthesia have to pay for the heart doctors. This could today run significantly gentler than 20 years ago. An 80-Year-old is less likely to risk through the ventilation later, lung or kidney damage. To this end, new surgical methods were. “That is to say, the chest must not be opened.”
“That was much too risky”
Wolfgang Harringer, President of the German society for thoracic-, cardiac – and vascular surgery, can well remember the past. “As I gave it to the end of the eighties as a heart surgeon started in patients over 70 no operations on the heart. It was much too risky,” he says.
Heart valve replacement or repair – it had previously been operations of three to four hours of open heart, anesthesia, and follow-up care in the ICU. Today, the takes around 60 minutes. The OP will run through the groin artery or vein. General anesthesia is only on desire.
With all these advantages, a shorter recovery phase is connected, and an improvement in the quality of life, says Harringer. He admits, however, that there is as yet no clear long-term results.
In addition, Harringer feels today’s Generation of Over-80-Year-old as a completely different than in the past. “The people are fitter and more active,” he summed up. “Many of them have a reasonable life style, and self-sufficient.” If old patient wanted an Operation really, you have often better candidates than some of the Younger, the smoke, as well as Diabetes and Obesity.
All the talk about it – and behavior still wrong
Cardiovascular diseases are in Germany continues to be a large Problem. Although the mortality rate decreased slightly, to follow the statistics of causes of death. With more than 338.000 deaths per year, they are diseases, from cancer. “However, despite all the talk about it, there are more large misconduct. From Smoking to Obesity,” says Hugo Katus, President of the German society for cardiology.
Added to this is a big difference between the States. Almost in the whole of Eastern Germany, more people die from the cardiac arrest than in the West. The age of the population or the long way of the ambulances in the country-rich as the sole explanation is not try.
The newer research believed that it is necessary to consider the causes of heart disease are more factors. “For example, the education level of the population and health information in rural regions,” says Andresen from the heart Foundation. Added to this are factors such as Obesity, Smoking rates and the number of pre-existing conditions such as Diabetes. In addition, work would need to be taken into account, unemployment rates and social Status, supplemented Katus.
More Knowledge is better than more cardiologists?
Already today we know that The more unique and widespread the support is, the greater the success. Otherwise, Smoking patients, even after SURGERY and rehab. It makes probably sense to inform people in socially weak districts and regions targeted. Bremen tried that already. More Knowledge would probably help more than a larger number of cardiologists, he says Katus.
The high age. Even those who live healthy, you can sometime get problems with the heart. And then? “With the operations of the heart does not decide the surgeon alone. Since the house first, doctors and the cardiologists upstream,” says surgeon Harringer. “It is always an individual consideration in the Team.”
When there are limits. “If members do not tremendous pressure, would be likely to operate no-one an elderly, bed-ridden dementia patient in a nursing home on the heart,” he says. “And a person over 80 with advanced cancer would not recommended.”
For seniors without serious pre-existing conditions, whether heart surgery is no longer as big of a risk. “It’s more quality of life.” Even if no one could estimate how many lives would be won years.
Striking is, however, that the procedures in Germany are not centralized – that is, that they are also carried out by smaller clinics. Since economic Considerations may play a role, says Harringer. “According to the currently available data, we can improve exclude nor corroborate that some of these OPs would be unnecessary, the clinic balance sheet as of the quality of life of patients.”