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[Myocardial revascularization interventions]

T Busch1, H Sârbu, M Friedrich

  • 1Klinik für Thorax-, Herz- und Gefässchirurgie, Georg August Universität Göttingen, Germany. hsirbu@gwdg.de

Chirurgia (Bucharest, Romania : 1990)
|October 2, 1998
PubMed
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Coronary artery bypass grafting (CABG) is a viable option for elderly patients over 70, offering symptomatic improvement with acceptable operative risk. Long-term survival rates at 5 years were 65.7%, supporting CABG for severe angina in this population.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Geriatric Medicine

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for severe coronary artery disease.
  • The safety and efficacy of CABG in elderly patients (septuagenarians) remain a subject of debate.
  • Increasing life expectancy leads to a growing number of elderly individuals requiring cardiac interventions.

Purpose of the Study:

  • To evaluate the clinical outcomes of coronary artery bypass grafting (CABG) in patients aged 70 and older.
  • To assess the short- and long-term results of CABG in this specific elderly cohort.
  • To determine if CABG is justifiable for elderly patients with severe angina.

Main Methods:

  • Retrospective analysis of 1127 patients over 70 who underwent myocardial revascularization between January 1985 and December 1996.

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  • Evaluation of clinical profiles, operative procedures, and postoperative outcomes (short- and long-term).
  • Analysis of trends in patient demographics, risk factors, surgical techniques, and perioperative complications.

    • Main Results:

    • The proportion of septuagenarians undergoing CABG increased significantly from 6.4% in 1985 to 21.5% in 1996.
    • Preoperative conditions included 87% in NYHA-class III/IV, with increasing prevalence of renal failure, obesity, and smoking history.
    • Perioperative mortality was 3.65%, hospital mortality was 9.64%, with 1-year and 5-year survival rates of 82% and 65.7%, respectively.

    Conclusions:

    • Coronary artery bypass grafting (CABG) can be safely performed in septuagenarian patients with acceptable operative risks.
    • The majority of elderly patients experience symptomatic improvement following CABG.
    • CABG is a recommended surgical option for a growing number of elderly patients suffering from severe angina.