Twenty-five patients between 80 and 89 years of age underwent a variety of cardiac surgical procedures. Operative mortality was 4%. Perioperative complications were frequent and resulted in an increased hospital stay postoperatively (mean 19.5 days). At a mean follow-up of 29.1 months, 21 patients (84%) are alive, with improvement in functional class from 3.4 to 2.0 (p less than 0.005). Cardiac operations can be performed in patients over 80 years of age with low mortality and significant symptomatic benefit. A high incidence of complications necessitates careful monitoring but should not represent a contraindication to the surgical management of advanced heart disease in this group.