[Indications and results of coronary surgery in patients aged 70 or more].
Among 400 consecutive patients who underwent coronary bypass performed by the same surgical team, 20 (5%) were aged 70 or more (mean: 71.52 years). This group represented one-third of coronary arteriographies carried out at that age. Most patients had stage III or IV coronary disease. All were seriously invalidated but in good general condition without systemic disease or dangerous arterial lesions. Coronary arteriography showed highly surgical lesions in all 20 cases, with 3-vessel lesions in 45% and tight stenosis of the main vessel in 25%. Ventricular function was generally normal. The average number of bypasses per patient (1.65) was distinctly lower than in younger subjects. The results obtained were most encouraging, with no death and no myocardial infarction either postoperatively or during a mean follow-up period of 2.5 years. Only 2 patients had residual angina. Compared with operated patients under 70, this group was characterized by a longer duration of the disease prior to surgery and by a higher percentage of severe clinical stages and life-threatening and highly surgical lesions. Post-operative and medium-term results were also distinctly better, probably because of stricter selection for surgery. All this has been confirmed in several North American publications which also report excellent results in patients over 70 years of age. To conclude, there are excellent reasons for performing coronary bypass in these elderly patients and age should not preclude pre-surgical arteriography, especially when the patient is seriously invalidated and when his general condition is sufficiently good to tolerate cardiopulmonary bypass.
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D013997:Time Factors
Indications et résultats de la chirurgie coronaire à 70 ans et plus.