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[Coronary artery bypass surgery in octogenarian]
K Ueyama1, H Ohashi, Y Tsutsumi
1Department of Surgery, Fukui Cardiovascular Center, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 31, 1999
Summary
Coronary artery bypass grafting (CABG) in patients over 80 years old showed satisfactory results, with no significant difference in hospital mortality compared to younger patients. Octogenarians should not be excluded from CABG based on age alone.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
Background:
- Advanced age presents unique challenges for cardiovascular interventions.
- Coronary artery bypass grafting (CABG) in octogenarians requires careful consideration of risks and benefits.
Purpose of the Study:
- To evaluate the safety and efficacy of CABG in patients aged 80 and older.
- To compare outcomes of CABG in octogenarians versus patients in their 70s.
Main Methods:
- Retrospective comparison of 14 patients aged 80+ (Group A) undergoing CABG with cardiopulmonary bypass versus 127 patients aged 70-79 (Group B).
- Analysis of preoperative comorbidities, intraoperative factors, and postoperative outcomes, including mortality and complications.
Main Results:
- Group A had higher rates of left main trunk stenosis, prior myocardial infarction, emergency operations, and preoperative intra-aortic balloon pump use.
- Postoperative complications like atrial arrhythmia and respiratory failure were more frequent in Group A.
- Hospital mortality was comparable between Group A (21.4%) and Group B (14.2%).
- 11 of 14 octogenarian patients were alive without angina recurrence post-CABG.
Conclusions:
- Despite increased preoperative risks and postoperative complications, CABG in octogenarians can yield satisfactory results.
- Age alone should not be a contraindication for CABG in elderly patients.
- Careful patient selection and management are crucial for successful CABG in the very elderly.