How Old Is Too Old for Surgery?

Dec. 31, 2006— -- First he made history as a surgeon. Then he made history as a patient.

As he stepped out of the Methodist Hospital in Houston this past September, Dr. Michael DeBakey -- at 97 -- became the oldest survivor of the operation he pioneered himself decades ago.

And though his survival is a testament to both human capacity and will, it also stands as an example of the ethical dilemmas that beset end-of-life care.

Earlier this year, DeBakey had a surgical repair of a dissecting aortic aneurysm -- a tear in the main artery leading from the heart. Aortic dissection is a medical emergency and can quickly lead to death, even with the best treatment.

But the decision to take DeBakey to surgery was not easy for his doctors because of the risks involved. The surgery had never been performed on a 97-year-old, and the chances of success were expected to be minimal at best.

Furthermore, DeBakey himself refused the operation for more than a month for fear of brain damage or permanent disability. But as his condition worsened he lost consciousness.

At this point his family and surgeons decided for him that he would have the surgery -- whether he wanted it or not.

Surgeons agreed that except for his age, DeBakey overall was in excellent health and had a good chance of making it through surgery.

After consulting with the ethics committee of the hospital and DeBakey's family, they decided to proceed.

The operation lasted more than seven hours but was a success. And after a prolonged recovery, DeBakey is doing well.

"Operations don't come any bigger than this," said Dr. Eugene Grossi, Chief of Thoracic Surgery at the New York Harbor Healthcare Veterans Administration Hospital in Manhattan.

The surgery was also unprecedented for a patient of DeBakey's age.

"While we do occasionally operate on patients in their 90s, this type of surgery is an exception," said Dr. Charles Lutz, Assistant Professor of Surgery and Director of the Robotic and Minimally Invasive Cardiac Surgery at SUNY Upstate Medical University in Syracuse, N.Y.

The operation throws the spotlight on the questions associated with operating on a patient of DeBakey's age.