In the past of China,both doctors and patients have historically been reluctant to pursue cardiac surgery in the elderly because of various reasons.Nowadays,this situation is changing.However,few studies have been performed to assess quality of life (QoL) in elderly patients after cardiac surgery in China.In this study,we evaluated long-term surgical outcomes and QoL and identified the factors associated with each in elderly patients who underwent cardiac surgery.Methods We recruited 320 patients aged ≥70 years old who underwent cardiac surgery in our hospital from January 2003 to December 2018.Risk factors for mortality were identified using a logistic regression analysis.Among survivors,QoL was assessed using the Short Form 36,and the results were compared to those in an age-matched population cohort in China.Results Overall hospital mortality was 7.2％.However,it has dropped to 3.7％ in the last five years.The 1-,3-,5-,and 10-year survival rates were 95.5％,85.7％,74.7％,and 30.5％,respectively.Cardiopulmonary bypass time and EuroSCOREs significantly predicted in-hospital mortality.Chronic pulmonary disease was the only risk factor for long-term mortality.Scores for bodily pain and role emotional were significantly higher in our population than in the general Chinese aged population.However,scores were lower for physical functions and vitality in our population than in the controls.Conclusions Cardiac surgery in elderly patients (≥70 years old) can have low in-hospital mortality,excellent long-term survival and high QoL,which are associated with comprehensive preoperative evaluation assesses and excellent perioperative management and post-surgery cardiac rehabilitation.