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[Emergent coronary artery bypass grafting (CABG) for over-80-year-old patients]
1Division of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji.
Insights
This study reports two emergent coronary artery bypass grafting (CABG) cases in patients over 80. Both elderly patients survived complex procedures, highlighting CABG feasibility in geriatric cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Coronary artery disease (CAD) poses significant risks in elderly patients.
- Emergent surgical intervention is sometimes necessary for severe CAD in octogenarians.
Abstract:
We experienced 2 emergent CABG for over-80-year-old patients. First patient, an 81-year-old male, showed total occlusion of left main truncus (LMT) and 90% stenosis of right coronary artery (RCA), and fell in shock. He underwent PTCA for LMT under intraaortic balloon pumping (IABP) and recovered from shock. But 3 days later, pulmonary congestion and heart failure developed along with mitral regurgitation. Emergent CABG to left anterior descending branch (LAD) and RCA was performed using saphenous vein grafts in combination with mitral annuloplasty by Kay's method. Second patient, an 82-year-old male, showed 50% stenosis of LMT, 99% stenosis of LAD and total occlusion of RCA, and fell in shock. Emergent CABG to LAD and RCA was performed using saphenous vein grafts under IABP. In spite of some perioperative serious complications, both patients survived and have been doing well. Some problems of CABG for elderly patients were discussed.