title: [Coronary angiography and coronary bypass in patients over 70 (valvular disease excluded). Indications and results].
abstract: Between 1982 and 1984, 30 patients aged 70 or over underwent coronary angiography for isolated coronary artery disease, complicated in 8 cases by an infarct and uncontrolled by major medical treatment, including triple therapy on 28 mmHg (range 5-30 mmHg). Coronary angiography was performed under intravenous trinitrin in 9 cases, under intra-aortic balloon pumping in 1 case, without any serious complications. The majority of patients had triple vessel disease (18 cases) and stenosis of anterior interventricular (27 cases). The left main stem was diseased in 5 patients. Twenty-four patients, with an EF of over 0.40, underwent a coronary bypass with an average of 27 grafts/patients; 4 myocardial infarcts and 5 postoperative deaths were observed. Nineteen patients survived at medium term follow-up and had an excellent clinical result. Of the non operated patients, there was one early death and 3 patients remained severely incapacitated. In the absence of a major contra-indication to surgery, coronary angiography can be offered to patients over 70 years old in cases of severe coronary insufficiency, resistant to major medical treatment. Coronary bypass is justified by the spectacular functional improvement which it alone can bring about.
mesh_terms: D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006801:Humans; D007485:Ioxaglic Acid; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012306:Risk; D014283:Triiodobenzoic Acids
chemical_list: D014283:Triiodobenzoic Acids; D007485:Ioxaglic Acid
vernacular_title: Coronarographie et pontage coronaire au-delà de 70 ans (valvulaires exclus). Indications et résultats.