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[Coronary artery bypass surgery in aged patients]
Y Kamikawa1, H Okabayashi, S Enomoto
1Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyuushuu, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 1997
Summary
Coronary artery bypass grafting in elderly patients over 80 showed similar mortality but increased complications and longer hospital stays. Careful postoperative management is crucial for these aged patients undergoing cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Coronary artery bypass grafting (CABG) is a common procedure.
- The number of elderly patients undergoing CABG is increasing.
- Outcomes in octogenarians and nonagenarians require specific evaluation.
Purpose of the Study:
- To evaluate the outcomes of isolated coronary artery bypass grafting in patients aged 60 and older.
- To compare outcomes across different age groups: 60-69, 70-79, and over 80 years.
- To identify specific risks and benefits of CABG in the oldest patient cohort.
Main Methods:
- Retrospective analysis of 749 isolated CABG patients from January 1993 to December 1996.
- Patients were stratified into three age groups: 60-69 (Group A, n=337), 70-79 (Group B, n=224), and >80 (Group C, n=17).
- Outcomes analyzed included mortality, duration of intubation, ICU stay, hospital stay, and postoperative complications.
Main Results:
- Mortality rates were similar across all age groups.
- Group C (>80 years) had a higher incidence of emergency cases and preoperative left ventricular (LV) dysfunction.
- Group C experienced longer intubation, ICU, and hospital stays, with more frequent complications like post-myocardial infarction (PMI), arrhythmia, and reoperation for bleeding.
Conclusions:
- Isolated CABG can be safely performed in elderly patients, including those over 80, with acceptable mortality.
- Significant functional benefits are achievable in aged populations.
- The oldest cohort (>80) faces a higher risk of complications, necessitating meticulous postoperative care and management strategies.