How to define the therapeutic limits
With the advance of technological progress and the increase in life expectancy, it is nowadays mandatory to define what is the therapeutic limit. Every day each physician must take therapeutic decisions on the basis of his scientific knowledge, but also of his own conscience and sense of limits. They can not avoid to consider the global risk of death, disability and morbidity in more advanced age, especially in the field of cardiology and cardiac surgery. In these subjects, both fit that frail, is necessary not only an evaluation for adequate risk assessment, but also a multidimensional assessment performed with advanced tools. The resilience of the subject, ability for which some patients considered out of therapy demonstrate the ability to adapt and overcome critical phases, must also be weighed. Where and what is the therapeutic limit should be evaluated individually with humility, competence and capacity for dialogue with other disciplines in a work team that respects the individual professionalism. In recent years, much has changed in the cardiology/cardiac surgery approach in old people. With the development of less or minimal invasive new techniques, there are no more insurmountable limits that can be connected only to the chronological age of the patients.
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