PMID- 2225409
OWN - NLM
STAT- MEDLINE
DCOM- 19901214
LR  - 20041117
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 82
IP  - 5 Suppl
DP  - 1990 Nov
TI  - Early and late results after isolated coronary artery bypass surgery in 159 
      patients aged 80 years and older.
PG  - IV229-36
AB  - We have studied 159 patients 80 years of age or older who have had isolated 
      coronary artery bypass grafting (CABG) since 1977. Eighty-seven percent have had 
      surgery since 1984. Two thirds of the patients were male, and the mean age was 82 
      years. Most patients (97%) were in New York Heart Association (NYHA) functional 
      class III or IV, 89% had unstable/postinfarction angina pectoris, and 67% had 
      rest pain. Almost half (47%) required preoperative admission to the coronary care 
      unit, 6% required preoperative use of an intra-aortic balloon pump, and 20% were 
      operated on emergently. Significant left main coronary artery disease (greater 
      than or equal to 50% stenosis) was present in 41%. Ten patients (6.3%) died 
      within 30 days of surgery, with seven more patients dying during the same 
      hospital admission or soon after transfer to another institution. This resulted 
      in an overall hospital mortality of 10.7%. The median hospital stay was 10 days. 
      On univariate analysis, the significant predictors of hospital mortality were 
      NYHA IV, angina at rest, preoperative admission to the coronary care unit, 
      emergency operation, ejection fraction less than 0.50, and the presence of mitral 
      regurgitation. On multivariate analysis, ejection fraction less than 0.50 was the 
      only significant risk factor (p less than 0.01). Of hospital survivors, 98% have 
      been followed for a mean of 29 months. The estimated 5-year survival (+/- SEM) of 
      all patients was 71 +/- 4.5%, and for hospital survivors, 80 +/- 4.5%. The most 
      important predictor of adverse survival was an ejection fraction less than 0.50. 
      Seventy-nine percent are angina-free, and 89% are in NYHA classes I and II. The 
      majority of patients felt that they were improved by surgery. We conclude that 
      CABG in patients 80 years or older, although associated with increased operative 
      risk, gives excellent relief of symptoms and good 5-year survival. Patients 
      should not be denied CABG because of age alone.
FAU - Mullany, C J
AU  - Mullany CJ
AD  - Division of Cardiothoracic Surgery, Mayo Clinic, Rochester, MN 55905.
FAU - Darling, G E
AU  - Darling GE
FAU - Pluth, J R
AU  - Pluth JR
FAU - Orszulak, T A
AU  - Orszulak TA
FAU - Schaff, H V
AU  - Schaff HV
FAU - Ilstrup, D M
AU  - Ilstrup DM
FAU - Gersh, B J
AU  - Gersh BJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass/*mortality
MH  - Coronary Disease/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Multivariate Analysis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survival Rate
MH  - Time Factors
EDAT- 1990/11/01 00:00
MHDA- 1990/11/01 00:01
CRDT- 1990/11/01 00:00
PHST- 1990/11/01 00:00 [pubmed]
PHST- 1990/11/01 00:01 [medline]
PHST- 1990/11/01 00:00 [entrez]
PST - ppublish
SO  - Circulation. 1990 Nov;82(5 Suppl):IV229-36.