Surgical treatment of angina pectoris in the elderly

We collected hospital and follow-up data for a consecutive series of 35 patients aged 65 years and over who underwent coronary artery bypass grafting for the relief of severe angina pectoris between January, 1974, and June, 1979. The inhospital mortality was 2.8% (one patient). Three patients (9%) suffered perioperative myocardial infaction, three (9%) were reoperated upon for early postoperative bleeding, and four (11%) had significant cerebrovascular complications. Only the latter rate differs significantly (P = 0.05) from the rate of complications reported in published series which include patients of all ages. Late mortality at a mean of 24.3 months follow-up was 12% (four late deaths). Relief of angina in survivors was excellent, with 20 of the 30 survivors (67%) free of chest pain at the time of follow-up. Twenty-five of the 30 survivors (82%) reported no limitation of their activities. Results in the elderly group were compared with those obtained for 322 consecutive patients of all ages, tha latter group having an operative mortality of 3.4%, a late mortality (at a mean of 15 months follow-up) of 12%, complete relief of angina in 62% and complete freedom from physical incapacity in 61% of survivors. Good short-term and long-term results can be obtained from coronary artery bypass grafting in symptomatic elderly patients, but with an increased risk of cerebrovascular complications.