[Emergency coronary artery bypass grafting in elderly patients]

Emergency coronary artery bypass grafting (CABG) in elderly patients still remains to be a therapeutic challenge for cardiac surgeons. The purpose of this study was to review the operative results of our emergency CABG in elderly patients and evaluate it's problems comparing with younger patients. Consecutive forty-three patients underwent emergency CABG for the past ten years were divided into two groups, that is 13 patients aged 75 years or older (group 1) and 30 younger than 75 years old (group 2). There were three in-hospital deaths (mortality rate: 23.1%) in group 1 and three (10.0%) in group 2. The lowest postoperative Ccr (19.1 +/- 8.9 ml/ min) in group 1 was significantly lower (p < 0.02) than that (35.6 +/- 14.4 ml/min) in group 2. Respiratory Index on the first postoperative day, which indicates lung dysfunction when it comes up to 2.0 or more, showed 2.65 in mean value in group 1 compared with 1.31 in group 2 (p < 0.05). Severe infections like sepsis were developed in 4 patients (30.8%) in group 1 and 2 (6.7%) in group 2 (p < 0.05). In conclusion, it was clearly suggested that kidney protection by earlier myocardial revascularization, prevention of severe infection and earlier introduction of respiratory physiotherapy in the postoperative period were advisable to improve the operative results of emergency CABG in elderly patients.