Abstract
Objectives: Coronary artery bypass grafting (CABG) is well established as an effective operation to overcome ischemic heart disease; however, the number of aged patients with a high operative risk undergoing this procedure has increased in recent years. This retrospective study evaluates our experience of performing CABG in a consecutive series of patients aged 75 years or older.Methods: To assess the hospital mortality and morbidity associated with this procedure, we retrospectively analyzed 49 patients aged 75 years or older (Elderly Group) who underwent CABG and compared the results with those of 88 patients aged 65–74 years (Control Group) who underwent CABG during the same period. Patients were examined for cerebrovascular diseases, and those with significant stenosis underwent pulsatile cardiopulmonary bypass. To avoid pulmonary complications, patients were extubated early.Results: The Control Group had a significantly higher incidence of arterial grafts than the Elderly Group (0.8±0.5 versus 0.3±0.5; p<0.0001). The Elderly Group had a significantly higher incidence of postoperative complications than the Control Group, with supraventricular arrhythmia in 57.1% versus 28.4%, (p=0.0009), delirium in 36.7% versus 11.4%, (p=0.0004), pneumonia in 6.1% versus 0%, (p=0.0439), and intubation duration of 88.3±212.5 hours versus 37.2±92 hours (p=0.0296), respectively. However, there was no significant difference in hospital mortality between the two groups, being 8.2% versus, 2.3%, in the Elderly group and Control Group, respectively (p=0.1867).Conclusion: These findings indicated that when elderly patients were appropriately managed, CABG could be performed with an acceptably low risk to mortality.
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Journal of Health and Welfare Statistics 1999; 46: 46–58.
Craver JM, Puskas JD, Weintraub WW, Shen Y, Guyton RA, Gott JP, et al. 601 octogenarians undergoing cardiac surgery: outcome and comparison with younger age groups. Ann Thorac Surg 1999; 67: 1104–10.
Glower DD, Christopher TD, Milano CA, White WD, Smith LR, Jones RH, et al. Performance status and outcome after coronary artery bypass grafting in persons aged 80 to 93 years. Am J Cardiol 1992; 70: 567–71.
Kirsch M, Guesnier L, LeBesnerais P, Hillion ML, Debauchez M, Seguin J, et al. Cardiac operations in octogenarians: perioperative risk factors for death and impaired autonomy. Ann Thorac Surg 1998; 66: 60–7.
Cane ME, Chen C, Bailey BM, Fernandez J, Laub GW, Anderson WA, et al. CABG in octogenarians: early and late events and actuarial survival in comparison with a matched population. Ann Thorac Surg 1995; 60: 1033–7.
Kawata T, Kitamura S, Taniguchi S, Kobayashi S, Mizuguchi K, Nishioka H, et al. Coronary artery bypass grafting in patients over 70 years old. Kyobu Geka 1997; 50: 678–81.
Kamikawa Y, Okabayashi H, Enomoto S, Tanabe A, Soga Y, Saito Y, et al. Coronary artery bypass surgery in aged patients. Kyobu Geka 1997; 50: 682–5.
Doi H, Umami T, Ohkawa Y, Sasaki A, Sugiki K, Ohno T. Coronary artery surgery in elderly patients. Kyobu Geka 1997; 50: 691–4.
Akins CW, Daggett WM, Vlahakes GJ, Hilgenberg AD, Torchiana DF, Madsen JC, et al. Cardiac operations in patients 80 years old and older. Ann Thorac Surg 1997; 64: 606–614; discussion 614-5.
Horvath KA, DiSesa VJ, Peigh PS, Couper GS, Collins Jr JJ, Cohn LH. Favorable results of coronary artery bypass grafting in patients older than 75 years. J Thorac Cardiovasc Surg, 1990, 99: 92–6.
Rich MW, Keller AJ, Schechtman KB, Marshall Jr WG, Kouchoukos NT. Morbidity and mortality of coronary bypass surgery in patients 75 years of age or older. Ann Thorac Surg 1988; 46: 638–44.
Rich MW, Sandza JG, Kleiger RE, Connors JP. Cardiac operations in over 80 years of age. J Thorac Cardiovasc Surg 1985; 90: 56–60.
Weintraub WS, Clements SD, Ware J, Craver JM, Cohen CL, Jones EL, et al. Coronary artery surgery in octogenarians. Am J Cardiol 1991; 68: 1530–4.
Utley JR, Leyland SA. Coronary artery bypass grafting in the octogenarians. J Thorac Cardiovasc Surg 1991; 101: 866–70.
Tsai TP, Nessim S, Kass RM, Chaux A, Gray RJ, Khan SS, et al. Morbidity and mortality after coronary artery bypass in octogenarians. Ann Thorac Surg 1991, 51: 983–6.
Williams DB, Carrillo RG, Traad EA, Wyatt CH, Grahowksi R, Wittels SH, et al. Determinants of operative mortality in octogenarians undergoing coronary bypass. Ann Thorac Surg 1995; 60:1038–1043.
Ura M, Sakata R, Nakayama Y. Coronary artery bypass surgery in patients over 75 years (Eng abstr). Kyobu Geka 1997; 50: 668–72.
Gardner TJ, Greene PS, Rykiel MF, Baumgartner WA, Cameron DE, Casale AS, et al. Routine use of the left internal mammary artery graft in the elderly. Ann Thorac Surg 1990; 49: 188–93; discussion 193-4.
Ennabli K, Pelletier LC. Morbidity and mortality of coronary artery surgery after the age of 70 years. Ann Thorac Surg 1986; 42: 197–200.
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Kobayashi, T., Hamano, K., Mikamo, A. et al. Perioperative features of coronary artery bypass grafting in patients aged 75 years or older. Jpn J Thorac Cardiovasc Surg 50, 152–157 (2002). https://doi.org/10.1007/BF02913196
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DOI: https://doi.org/10.1007/BF02913196