PMID- 8180747
OWN - NLM
STAT- MEDLINE
DCOM- 19940616
LR  - 20191023
IS  - 0954-6928 (Print)
IS  - 0954-6928 (Linking)
VI  - 5
IP  - 2
DP  - 1994 Feb
TI  - How safe is coronary bypass surgery in the elderly patient? Analysis of 111 
      patients aged 75 years or more and 2939 patients younger than 75 years undergoing 
      coronary artery bypass grafting in a private hospital.
PG  - 169-74
AB  - AIM AND METHODS: Data from patients younger than 75 years (group I, n = 2939) and 
      patients aged 75 years or older (group II, n = 111) who underwent isolated 
      coronary artery bypass grafting (CABG) during a 9-year period (January 1984 to 
      April 1993) were analyzed to determine comparative risk factors for morbidity, 
      early and late survival, and functional outcome. RESULTS: Traditional risk 
      factors (hypertension, hyperlipidemia, diabetes mellitus, and smoking) were 
      significantly more prevalent in group II. The number of patients in New York 
      Heart Association (NYHA) functional classes 3 and 4 before surgery was also 
      significantly higher in group II (P < 0.001), but emergency operations were 
      equally distributed between the groups. Left main-stem stenosis was more frequent 
      in group II patients (P < 0.01), while the number of vessels involved and 
      pre-operative left ventricular function did not differ. Both groups underwent a 
      mean of 4.5 grafts. Internal mammary grafts were placed in 48.4% (1422/2939) in 
      group I and 19.8% (22/111) in group II (P < 0.001). The overall peri-operative 
      mortality rate did not differ between the groups (2.9% for group I and 2.7% for 
      group II). Non-fatal peri-operative myocardial infarction, ventricular 
      arrhythmias, post-extracorporeal circulation disorientation, and temporary renal 
      insufficiency were more prevalent in group II patients (all P < 0.05). Emergency 
      operations and re-operative CABG increased the peri-operative mortality in both 
      groups. The 3-year survival rate was 93% and the 3-year cardiac event-free rate 
      was 88% for the group II patients. Most of the elderly patients (98%) were in 
      NYHA functional classes 1 and 2 at the end of the follow-up. CONCLUSIONS: Even if 
      elderly patients have a slightly higher postoperative morbidity than younger 
      patients, and an increased mortality if operated upon in an emergency, long-term 
      survival and freedom from cardiac events are excellent and justify the continued 
      performance of CABG in patients aged 75 years of age or more.
FAU - Christenson, J T
AU  - Christenson JT
AD  - Cardiovascular Unit, Hopital de la Tour, Geneva, Switzerland.
FAU - Schmuziger, M
AU  - Schmuziger M
FAU - Maurice, J
AU  - Maurice J
FAU - Simonet, F
AU  - Simonet F
FAU - Velebit, V
AU  - Velebit V
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Activities of Daily Living
MH  - Acute Kidney Injury/epidemiology
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Arrhythmias, Cardiac/epidemiology
MH  - Coronary Artery Bypass/adverse effects/methods/mortality/*statistics & numerical 
      data
MH  - Coronary Disease/pathology/surgery
MH  - Endarterectomy
MH  - Female
MH  - Follow-Up Studies
MH  - Hospitals, Private
MH  - Humans
MH  - Internal Mammary-Coronary Artery Anastomosis
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/epidemiology
MH  - Reoperation/statistics & numerical data
MH  - Risk Factors
MH  - Survival Rate
MH  - Switzerland/epidemiology
MH  - Treatment Outcome
EDAT- 1994/02/01 00:00
MHDA- 1994/02/01 00:01
CRDT- 1994/02/01 00:00
PHST- 1994/02/01 00:00 [pubmed]
PHST- 1994/02/01 00:01 [medline]
PHST- 1994/02/01 00:00 [entrez]
AID - 10.1097/00019501-199402000-00011 [doi]
PST - ppublish
SO  - Coron Artery Dis. 1994 Feb;5(2):169-74. doi: 10.1097/00019501-199402000-00011.