[Myocardial revascularization interventions].
Elective coronary artery bypass surgery (CABG) can be performed with low operative mortality. There is a controversial discussion whether short- and long-term results of CABG can justify this procedure even in elderly patients.


METHODS
We retrospectively evaluated the clinical profile, operative procedure, postoperative short- and long-term results of 1127 patients over 70 years of age who underwent myocardial revascularization between January 1985 and December 1996.


RESULTS
Mean age was 73.9 years. In 1996, septuagenarians represented 21.5% of our operated coronary patients, when compared with 6.4% in 1985. Analysis of risk factors showed an increasing prevalence of renal failure, obesity, hyperuricemia and a history of smoking. Preoperatively 87% of our patients were in NYHA-class III and IV. The percentage of emergent operations decreased over the observed period by 10.3%. Internal mammary artery was used with increasing frequency (44.8% in 1985-92 vs. 61.5% in 1993-96). The number of simultaneous valve replacements increased, too. Postoperatively, we noted rising incidence of respiratory failure (17.1%) and neurological disorders (13.7%). On the other hand, the need for intraaortic balloon pumping and hemofiltration declined by 6.6% and 2.9%. Perioperative mortality (< or = 24 h) was 3.65%, hospital mortality (< or = 30 days) was 9.64%. Actuarial 1 year at was 82% (+/- 4.3%), and 65.7% (+/- 3.8%) at 5 years.


CONCLUSIONS
Our data suggest that CABG can be performed in septuagenarians with an acceptable operative risk. Since the large majority of patients improve symptomatically, surgery is the recommendable option for a growing number of elderly patients suffering from severe angina.
Klinik für Thorax-, Herz- und Gefässchirurgie, Georg August Universität Göttingen, Germany. hsirbu@gwdg.de
T
T
Busch
H
H
Sârbu
M
M
Friedrich
C
C
Stamm
H
H
Dalichau
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors
Intervenţiile de revascularizaţie miocardică.