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Elective aortocoronary bypass grafting in the elderly
M F Matangi1, J A Strickland, J J Burgess
1Section of Cardiology, Plains Health Centre, Regina, Saskatchewan.
The Canadian Journal of Cardiology
|October 1, 1987
Summary
Elderly patients over 65 undergoing elective aortocoronary bypass grafting experienced low operative mortality (1.6%) and good long-term survival (93% at five years). Most patients reported satisfaction and relief from angina pectoris.
Area of Science:
- Cardiology
- Geriatric Medicine
- Surgical Outcomes
Background:
- Coronary artery disease (CAD) significantly impacts elderly populations.
- Symptomatic angina pectoris in older adults presents management challenges.
- Elective aortocoronary bypass grafting (ACBG) is a potential intervention for symptomatic CAD.
Purpose of the Study:
- To evaluate the safety and efficacy of ACBG in patients over 65.
- To assess operative mortality, postoperative morbidity, and long-term outcomes.
- To determine the impact of ACBG on angina relief and survival in elderly patients.
Main Methods:
- Retrospective analysis of 122 patients aged over 65 undergoing elective ACBG.
- Data collected from January 1980 to December 1985.
- Follow-up of survivors to assess long-term survival and clinical events.
Main Results:
- Low in-hospital mortality rate of 1.6% (2 deaths).
- Perioperative myocardial infarction occurred in 9.8% of patients.
- Five-year survival probability was 93%; event-free survival was 72%.
- 90% of patients reported satisfaction; 78% were angina-free post-surgery.
Conclusions:
- ACBG is effective and safe for selected low-risk elderly patients with symptomatic CAD.
- The procedure provides significant symptomatic relief and improves long-term survival.
- ACBG should be considered for elderly patients with severe angina pectoris.