Coronary artery bypass surgery in the elderly: experience of tertiary care hospital

Area of Science:

• Cardiology
• Geriatric Medicine
• Cardiac Surgery

Background:

• Improving life expectancy in the subcontinent leads to an increase in elderly patients needing coronary artery bypass.
• Elderly patients face higher mortality risks, often leading to reluctance in performing surgery due to perceived unfavorable cost-benefit ratios.

Purpose of the Study:

• To review the outcomes of coronary artery bypass operations in patients aged 70 years and older.
• To assess the early and late mortality and morbidity in this elderly cohort.

Main Methods:

• Retrospective review of patient records for coronary revascularization procedures.
• Analysis of data from 1995 to 2004, including 3,312 total operations, with a focus on 242 patients aged >=70 years.
• Assessment of preoperative risk factors (e.g., EuroSCORE) and postoperative outcomes (mortality, morbidity, functional class).

Main Results:

• Out of 3,312 coronary bypass operations, 242 (7.3%) were performed on patients >=70 years old.
• Early postoperative mortality was 8.7% (21/242), with 13.6% experiencing morbidity.
• One-year follow-up showed 1.7% late deaths (non-cardiac); preoperative functional class significantly predicted postoperative outcomes.

Conclusions:

• Coronary artery bypass surgery in carefully selected elderly patients can yield beneficial outcomes.
• Meticulous patient selection is crucial for optimizing the benefits of coronary artery bypass in geriatric populations.
• The study suggests that age alone should not be a contraindication for coronary revascularization in the elderly.