title: Coronary angioplasty in octogenarians: comparisons to coronary bypass surgery.
abstract: Coronary angioplasty was performed in 74 patients 80 years of age and older (mean 83 +/- 3). Single vessel coronary disease was present in 34% and multivessel coronary disease in 66%. Angioplasty of a single vessel was performed in 51 patients (69%), while 23 (31%) had angioplasty of multiple vessels. Angioplasty was successful in 59 of 74 patients (80%). Angioplasty was unsuccessful but uncomplicated in 12 (16%) due to (unyielding) calcified lesions or (impassable) old occlusions. Of these 12, 8 were discharged on medical therapy and 4 underwent elective uncomplicated bypass surgery prior to discharge. Three (4%) patients required emergency coronary bypass surgery due to abrupt vessel closure during the angioplasty procedure, with one hospital death (1.4%). Follow-up (mean 24 +/- 22 months) was obtained in all patients. Of the 59 successful angioplasty patients, late mortality was 10% (cardiac 7% and non-cardiac 3%). Survival and survival without myocardial infarction were both 90%; survival without either infarction or bypass surgery was 86%. Actuarial 3-year survival was 91% and 3-year freedom from death, infarction or bypass surgery was 87% by life-table analysis. Repeat angioplasty for restenosis was performed in 7 patients (12%) without complications.
authors.affiliation: San Francisco Heart Institute, Seton Medical Center, Daly City, CA 94015.
authors.forename: R K
authors.initials: RK
authors.lastname: Myler
authors.forename: J G
authors.initials: JG
authors.lastname: Webb
authors.forename: K P
authors.initials: KP
authors.lastname: Nguyen
authors.forename: R E
authors.initials: RE
authors.lastname: Shaw
authors.forename: A
authors.initials: A
authors.lastname: Anwar
authors.forename: N S
authors.initials: NS
authors.lastname: Schechtmann
authors.forename: T T
authors.initials: TT
authors.lastname: Bashour
authors.forename: S H
authors.initials: SH
authors.lastname: Stertzer
authors.forename: A
authors.initials: A
authors.lastname: Zapolanski
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015996:Survival Rate; D013997:Time Factors