Myocardial revascularisation in patients over seventy five years

A consecutive series of 73 patients aged 75 years and above underwent coronary artery bypass graft surgery during a 6 year period. Pre-operatively unstable angina (61.6%) and congestive heart failure (10.9%) were significant presenting features. Triple vessel disease accounted for 61.6% of cases while 26% had left main coronary obstruction. The mean number of grafts per patient was 3.2 +/- 0.9. Combined procedures such as valve replacement were done in 16.2% of patients. The hospital mortality rate was 2.7% and there was not a single recordable case of peri-operative myocardial infarction. Significant complications post-operatively were atrial arrhythmias (43.8%), segmental pulmonary atelectasis (43.8%) and renal problems (15%). Of the sixty patients followed up at an average of 27.7 months, 58 were in NYHA Functional Class I. Good patient selection and careful monitoring leads to encouraging results with coronary artery bypass grafting in the elderly.