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Coronary Artery Disease I: Introduction

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...

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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

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Coronary artery bypass surgery in the elderly.

B A Hibler, J O Wright, C B Wright

Archives of Surgery (Chicago, Ill. : 1960)

|April 1, 1983

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Elderly patients undergoing coronary artery bypass grafting (CABG) showed a 5% operative mortality. However, 81% experienced clinical improvement and 91% survived one year, indicating good outcomes for carefully selected older adults.

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Published on: September 15, 2023

Area of Science:

Cardiovascular Surgery
Geriatric Medicine
Cardiac Surgery Outcomes

Background:

Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
Outcomes in elderly patients (over 65) undergoing CABG require specific evaluation.
Assessing risk factors and long-term prognosis is crucial for this demographic.

Purpose of the Study:

To evaluate the outcomes of coronary artery bypass grafting (CABG) in patients over 65 years of age.
To identify risk factors associated with increased operative mortality in this elderly cohort.
To determine the clinical improvement and survival rates at one year post-CABG.

Main Methods:

Retrospective analysis of 115 patients aged over 65 who underwent CABG.
Comparison of operative mortality with a historical cohort of 1,500 CABG patients.
Identification of risk factors including New York Heart Association (NYHA) class, ejection fraction, disease extent, and age.

Main Results:

Operative mortality was 5% in the elderly group, compared to 2.5% overall.
Increased risk factors identified: NYHA class IV, ejection fraction <35%, >5 grafts, age >75.
At one year, 81% were clinically improved, and 91% survived.

Conclusions:

Elderly patients undergoing CABG have a higher operative mortality than the general population.
Specific factors like NYHA class IV, poor ejection fraction, extensive disease, and advanced age increase risk.
Selected elderly patients (NYHA II-III, good LV function, ≤4 grafts) have excellent short- and long-term prognoses after CABG.