[Coronary artery bypass surgery in patients over 75 years]

Coronary artery bypass graft surgery is increasingly common in patients over 75 years. In our institution, a consecutive series of 936 patients undergoing isolated CABG between May 1988 and July 1996 included 154 patients older than 75 years. These elderly patients were divided into two group (group A: 40 patients over 80 years old, group B: 114 patients younger than 80 years) and the patients in group A and group B were compared with 100 consecutive patients younger than 75 years who underwent CABG in 1996 (group C). Mean age for elderly patients was 78.1 and for group C patients 64.2 years. Emergency operation and preoperative use of IABP were significantly frequent in group A (p < 0.05). Left main trunk stenosis was more frequent in group A patients (p < 0.05), while the number of diseased vessels did not differ. Mean number of grafts and arterial grafts were higher for group C patients. The frequency of use of arterial grafts in elective cases were lower for group A and group B patients. (p < 0.05, 86.3% group A, 91.3% group B, 100% group C). Although the frequency of mediastinitis and long stay of ICU (over 5 days) were significantly higher in group A (p < 0.05) and older patients tended to have higher postoperative morbidity, the hospital mortality did not differ between the groups (5.0% group A, 4.4% group B, 1.0% group C). We conclude that CABG in patients over 75 years of age can be performed with acceptable mortality. Patients should not be denied CABG because of age alone.