[Surgical complications and mortality in octogenarian patients undergoing revascularization surgery]

Our objective was to identify preoperative, operative and postoperative factors associated with complications and mortality in patients equal to or greater than 70 years of age with coronary artery disease treated with coronary bypass surgery. From january 1990 to june 1994 of those that underwent 37 coronary artery bypass surgery. 32 were men (86.5%) and five women (13.5%). History of cardiovascular disease, diabetes mellitus, systemic arterial hypertension, pulmonary disease, hypercholesterolemia, renal function, and severity of coronary artery disease were considered. Also analysed were aortic clamp and cardiopulmonary bypass time, number and type of grafts. Use of intraaortic balloon counterpulsation, inotropic drugs, ventilatory support, hemorrhage, infection, renal and liver failure, neurological, rhythm and conduction abnormalities and myocardial ischemia were also considered. Identified risk factors: diabetes mellitus, (p = 0.028), ejection fraction < 30% (p = 0.023), ventricular wall motion abnormalities (p < 0.05), aortic clamp > 60 minutes (p = 0.026), cardiopulmonary bypass < 120 minutes (p = 0.022), reverse saphenous vein grafts (p = 0.014), prolonged ventilatory support, inotropic drugs and intraaortic balloon counterpulsation.

Surgery should be reserved for patients with at least three vessel or left main coronary artery disease or proximal lesion of the left anterior descending artery with severe ischemia, deteriorated myocardial function and angina with no response to medical treatment; age of the patient is not a contraindication.