[Coronary artery bypass grafting in patients over 70 years of age]

The purpose of this study was to assess the risk of coronary artery bypass grafting (CABG) in the group of patients (pts) over 70 years of age and to examine results of surgical treatment in these pts. Between January 1993 to December 1999 1276 pts underwent CABG. From this group 114 consecutive pts at the age over 70 were retrospectively studied. The average age of the pts was 71.8 +/- 2.2 years (range, 70 to 79 years). Eighty nine male (78.1%) and 25 female (21.9%) pts were operated. One or more myocardial infarction had occurred in 64.0% of pts preoperatively. All the pts underwent left cardiac catheterization. The indication for surgery was significant stenosis of the left main trunk in 35 (30.7%) pts and three vessels disease in 54 (47.4%) pts. The total number of peripheral anastomoses was 274 (average 2.4 +/- 0.9 grafts per pts). In 29 cases left internal mammary artery (to left anterior descending artery) and in 245 reversed saphenous vein grafts were used. The early postoperative mortality in the group of pts at the age over 70 (10 pts--8.8%) was significantly higher than in the group of younger pts (41 of 1162 pts). The cause of death in septuagenarians was: low cardiac output syndrome (5 pts), respiratory failure (2 pts), renal insufficiency (2 pts) and cerebral stroke (1 pt). In early postoperative course the incidence of any organ insufficiency (cardiac, respiratory, renal and neurological) was higher in the group of pts over 70 years of age than in the younger pts. Seven-year probability of survival calculated from Kaplan-Meier method was 66 +/- 4%. After operation 84.5% of pts were asymptomatic, while only 5 pts were in III and IV CCS functional class. CABG in pts at the age over 70 is associated with higher operative risk and higher rate of perioperative organ failure. After surgery most pts enjoy improvement in life quality.