Favorable results of coronary artery bypass and/or valve replacement in octogenarians.
Between October 1987 and July 1990, of 763 patients undergoing open heart surgery, 43 (5.6%) were 80 (mean and median 82) years of age or older. There were 20 men and 23 women. Eighteen patients (42%) were initially assessed using the angina score of the New York Heart Association or Canadian Cardiovascular Association as class IV. Nine procedures (21%) were performed electively and 34 (79%) urgently. A total of 26 patients (60%) underwent coronary bypass surgery, while 11 (26%) had valve replacements and six (14%) had both coronary bypass surgery and valve replacement; 74% of the patients received two or more grafts. The hospital mortality rate of the octogenarian patients was 9% (four of 43), significantly higher (P < 0.05) than the overall hospital mortality rate of 3.6% for patients < or = 79 years of age. A history of myocardial infarction within 2 weeks before the procedure was obtained in nine of 43 patients (21%); 22 (51%) had experienced at least one myocardial infarction before surgery. Ejection fractions were 'normal' in 28 patients (65%), 'fair' in nine (21%) and 'poor' in six (14%). The mean length of hospital stay for the octogenarian patients was 19 (range 8-64) days. Thirty-five of the 39 operative survivors were followed for a mean of 14 (range 3-35) months. The actuarial probability of survival was 86% at the end of this time. A total of 31 patients (79%) assessed using the angina score of the New York Heart Association or Canadian Cardiovascular Association were class I or II. During the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)
Yashar
J J
JJ
Division of Cardiac Surgery, Miriam Hospital, Providence, Rhode Island.
Yashar
A G
AG
Torres
D
D
Hittner
K
K
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate