[Coronary artery bypass surgery in patients older than 75 years of age]

There is controversy whether the short-term and long-term results of coronary artery bypass surgery in elderly patients justify the commencement of the procedure. Between February 1988 and July 1992, 113 patients underwent CABG in our hospital, of whom 15 (13.3%) patients were 75 years old or older (mean 76 years). They consisted of 5 men and 10 women, and all were in New York Heart Association class III or IV. Unstable angina was observed in 13, left main trunk stenosis was in 4, and left ventricular dysfunction, ejection fraction of less than 0.30 was in 2 of 15 patients. The mean number of bypass grafts was 2.7 per a patient, and only autologous greater saphenous vein was used. In seven (47%) cases, CABG was performed urgently or emergently. There was neither operative nor hospital death, although some complications occurred in 11 (73%) patients. Post-operatively, 13 patients were in NYHA class I and 2 in class II. Only one patient died of pneumonia one year after operation. Although high risks of operative mortality and morbidity with coronary artery bypass surgery for elderly patients, particularly in urgent or emergent cases, had been reported, the long-term survival rate and freedom from angina were excellent, justifying continuous commencement of coronary bypass surgery in the selected patients over 75 years of age.