Coronary artery bypass grafting in octogenarians.
Preoperative profiles, postoperative complications, and the early and late results in 32 patients 80 yrs. of age and older (elderly group) who underwent coronary artery bypass grafting were compared with those in patients under 80 yrs. of age (control group). In the elderly group, the prevalence of patients with preoperative creatinine clearance (Ccr.) <50 l/day (34.4%), unstable angina pectoris (78.1%) and left main trunk disease (40.1%) was significantly higher than those in the control group. The incidences of arrhythmia and intensive care unit(ICU) syndrome were also significantly higher in the elderly group than in the control group, however, there was no death due to these complications. In the elderly group, one patient (3.1%) died in the hospital due to low cardiac output syndrome (LOS), while three patients (2.4%) of the control group died in the hospital. As for the long-term results, the 5-yr. survival rates for the elderly group and the control group were 82.6% and 85.2%, respectively, and the effectiveness of surgery was remarkable, with improved postoperative activity in 96.9% of the elderly group. These findings indicate that although the elderly patients have higher risks by undergoing surgery and have a disadvantage in the rate of postoperative complications, the postoperative improvement in activity and survival rate can be similar to those in the younger patients.
Sakamoto
S
S
Department of Thoracic and Cardiovascular Surgery, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan. cardsurg@kanazawamed-ac.jp
Matsubara
J
J
Matsubara
T
T
Nagayoshi
Y
Y
Nishizawa
H
H
Shouno
S
S
Kouno
M
M
Takeuchi
K
K
Nonaka
T
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D001806:Blood Urea Nitrogen; D002303:Cardiac Output, Low / Q000209:etiology / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003401:Creatine / Q000097:blood; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D013995:Time; D017725:Ventricular Pressure / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology
D003401:Creatine