[Aortocoronary venous bypass operation in the elderly].
On the extended diagnosis for an aorto-coronary venous bypass operation, with a greater involvement of patients with instable angina pectoris symptomatik (inApS), left main artery disease (LAD), aneurysmal resection, and "bad" ventricle (ejection fraction global less than or equal to 30%), the preoperative risk was evaluated in n = 600 patients. In a total of n = 150 patients with preoperative high-risk constellation perioperative parameters were monitored to find complications (perioperative myocardial damage [PMD], cardiac low output syndrome [LOS]). Among them were n = 40 patients aged greater than 60 years (60-72), their average age being 62.9 years. In 30% of these older patients the preoperative high-risk constellation was confirmed: 15% PMD, 10% LOS, and 5% deceased. The further postoperative course (up to the 6th month) is objectified by the ejection fraction global (EFg) by multiple checks. As a whole, patients greater than 60 years with extended diagnosis for ACVB operation do not show any significant increase in hospital mortality, but an increase in PMD and LOS (p less than 0.001) compared to the age group less than 60 years. With corresponding individual intensive-therapeutic measures, however, both complications can be controlled in the majority of patients. Despite the demonstrated higher perioperative risk, the urgent ACVB operation proved to be strategically right (considering the results of EFg) for increasing the quality of life and improving the expectation of life also for patientes greater than 60 years, in particular with the operation indications of inApS and LAD.(ABSTRACT TRUNCATED AT 250 WORDS)
Kothe
V K
VK
Universitätsklinik für Innere Medizin, Bereiches Medizin (Charité) der Humboldt Universität zu Berlin.
Porstmann
B
B
Aurisch
R
R
Butzeck
J
J
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000787:Angina Pectoris / Q000601:surgery*; D000789:Angina, Unstable / Q000601:surgery; D002302:Cardiac Output; D002303:Cardiac Output, Low / Q000175:diagnosis*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D003402:Creatine Kinase / Q000097:blood; D006322:Heart Aneurysm / Q000601:surgery; D006801:Humans; D007527:Isoenzymes; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D015879:Myosin Subfragments / Q000097:blood; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D012307:Risk Factors
D007527:Isoenzymes; D009211:Myoglobin; D015879:Myosin Subfragments; D000410:Alanine Transaminase; D003402:Creatine Kinase
Aortokoronare Venen-Bypass-Operation im höheren Lebensalter.