[Coronary surgery in patients aged 70 years and older. 65 cases]

Out of 428 patients operated upon for coronary disease between December 1984 and November 1989, sixty-five (15.18 percent) were 70 to 80 years' old. All were suffering from a more or less invalidating stage II, III or IV angina. Coronary arteriography showed severe lesions of two or three main vessels (24.6 and 60 percent respectively). Each patient underwent 2.06 bypasses on average. Perioperative mortality was 7.7 percent, and late mortality 1.53 percent. The postoperative myocardial infarction rate was 4.61 percent, and 83 percent of these patients became asymptomatic. There was no deterioration. These satisfactory results are the consequences of numerous technical advances in cardiovascular surgery, anaesthesia and intensive care. As more and more elderly patients undergo coronary surgery, the desire of other elderly patients to be operated upon and their comfort after coronary surgery, the desire of other elderly patients to be operated upon and their comfort after coronary bypass are two additional reasons to opt for surgery. In spite of new vascular recanalization techniques, coronary surgery remains of considerable value. Close cooperation between surgical and medical teams should clarify the respective indications for coronary angioplasty and direct coronary bypass, thereby making these two procedures complementary and no longer competitive.