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[Coronary angiography after the age of 70 years]
Insights
Coronary angiography in patients over 70 is useful for valvular disease assessment, though risks are higher. Surgery improved survival for valvular disease patients, but grafting showed no survival benefit in this age group.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Coronary angiography indications and risks differ in patients over 70.
- Valvular heart disease is a primary indication for angiography in this demographic.
- The procedure carries a higher mortality risk in the elderly compared to younger populations.
Purpose of the Study:
- To evaluate the utility and outcomes of coronary angiography in patients aged 70 and above.
- To assess the impact of surgical intervention on survival in elderly patients with valvular disease.
- To determine the role of coronary artery bypass grafting in conjunction with valvular surgery.
Main Methods:
- Retrospective analysis of 100 patients over 70 undergoing coronary angiography.
- Assessment of indications for the procedure, including valvular disease evaluation.
- Comparison of survival rates between operated (with or without grafting) and non-operated patients.
Main Results:
- Coronary angiography was frequently indicated for valvular disease assessment (58%).
- Two deaths occurred in the series, indicating a higher procedural risk.
- Operated patients with valvular disease demonstrated improved survival compared to inoperable or non-operated counterparts.
- No significant survival difference was observed between grafted and non-operated patients.
Conclusions:
- Coronary angiography is a valuable tool in elderly patients with valvular disease for surgical planning.
- Surgical intervention for valvular disease in patients over 70 is associated with enhanced survival.
- Coronary artery bypass grafting does not appear to confer additional survival benefits in this specific elderly cohort undergoing valvular surgery.
Abstract:
100 patients over the age of 70 years underwent coronary angiography. The indications for this examination at this age were different from those in younger patients. After the age of 70 years, 58 per cent of coronary angiographies are performed as part of the haemodynamic survey of valvular disease. The risk of the examination appears to be higher, as two deaths occurred in this small series, while the mortality is estimated to be 2 per thousand in younger patients. Coronary angiography is very useful at this age in patients with valvular disease to determine the need for an associated coronary graft and also to determine contraindications for operation because of the severity of the lesions. A surgical indication was confirmed in 50 patients, but surgery was only performed in 36 of them. The follow-up of these patients demonstrates that patients operated for valvular disease had a longer survival that those considered to be inoperable or who refused operation. On the other hand, there was no difference in survival between grafted and non-operated patients over the age of 70 years.