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[Surgery of coronary revascularization in patients over 70. Apropos of 40 cases]
J Seguin1, P Coulon, R Grolleau
1Service de Chirurgie thoracique et cardiovasculaire, Hôpital Saint-Eloi, Montpellier.
Insights
Aorto-coronary bypass grafting is safe for patients over 70 years old. This study shows acceptable operative risks and satisfactory long-term results for elderly individuals undergoing this cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
Context:
- Aorto-coronary bypass grafting (CABG) is a common procedure for coronary artery disease.
- Elderly patients (over 70) present unique challenges for cardiac surgery due to comorbidities and physiological changes.
Purpose:
- To evaluate the safety and efficacy of CABG in patients aged 70 years and older.
- To assess peri-operative outcomes and long-term results in this specific demographic.
Summary:
- A cohort of 40 patients over 70 underwent CABG between 1980-1984.
- The average age was 71.1 years, with 25 patients having severe angina and 15 requiring emergency surgery.
- Peri-operative mortality was 7.5% (3 deaths), with 3 peri-operative myocardial infarcts. Mean follow-up was 21 months, showing 2 late myocardial infarctions and 32 asymptomatic patients.
Impact:
- Advances in cardiac surgery, anesthesia, and postoperative care have made CABG a viable option for elderly patients.
- The study demonstrates that CABG can be performed in patients over 70 with acceptable operative risk and favorable long-term outcomes.
- This supports the consideration of revascularization strategies for older adults with significant coronary artery disease.
Abstract:
40 of the 900 patients operated upon for aorto-coronary bypass grafting between January 1980 and October 1984, were over 70 years old (mean 71.1; range: 70-76 years old). 25 had severe angina pectoris (class III or IV) and 15 of them had emergency surgery. An average of 2 grafts per patient was performed with 3 deaths and 3 myocardial infarcts in the peri-operative period. Patients had an average of 21 months follow-up (range 5 years, 3 months); in that period 2 deaths due to myocardial infarction, 3 persistent angina pectoris (class II) and 32 asymptomatic patients were observed. These results illustrate advances in cardiac surgery, anesthesia and postoperative management. Coronary surgery may therefore be performed in patients over 70 years old with an acceptable operative risk and satisfactory longterm results.