title: [Results of isolated and combined surgical coronary revascularization in patients over 75].
abstract: BACKGROUND
  Increase in life expectancy is causing an increase of surgical myocardial revascularization procedures in the elderly. We evaluate the evolution of this type of interventions in people older than 75 years, taking into account the risk factors, results and survival.
  
  
  METHODS
  Between July 1988 and May 2001, 237 isolated or combined myocardial revascularization procedures were carried out in patients older than 75 years (Group I), while 1177 were performed in younger patients (Group II). We retrospectively analyzed the mortality risk factors, surgical procedures, postoperative complications and survival in Group I patients.
  
  
  RESULTS
  Preoperatively, Group I patients showed a more frequent left ventricular dysfunction, left main coronary stenosis, emergency surgery and combined procedures, while Group II patients displayed more common preoperative myocardial infarction and dyslipemia. Mortality in Group I was 20.7% vs 9.09% in Group II. Mortality was higher for mixed procedures (27.1%) than for isolated myocardial revascularization (13.8%). Postoperative complications were present in 48.5% patients. Significant preoperative risk factors of mortality in Group I were: female sex, high-risk ergometry, III-IV NYHA functional class, and atrial arrhythmia. The preoperative NYHA functional class was also a morbidity risk factor. Survival at 1, 3 and 5 years was present in 98.4%, 92.1% and 81% patients, respectively, NYHA functional class I-II being present in 94.18% patients.
  
  
  CONCLUSIONS
  Myocardial revascularization surgery in people older than 75 years leads to an increase of morbimortality. Anyway, long-term survivors' quality of life makes us think of surgery as a valid treatment alternative.
authors.affiliation: Servicio de Cirugía Cardíaca, ICICOR, Hospital Universitario de Valladolid, Valladolid, España. aguerrerop@medynet.com
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Carrascal
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Echevarría
authors.forename: Enrique
authors.initials: E
authors.lastname: Fulquet
authors.forename: Elena
authors.initials: E
authors.lastname: Casquero
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Stefano
authors.forename: Santiago
authors.initials: S
authors.lastname: Flórez
authors.forename: Luis
authors.initials: L
authors.lastname: Fiz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods / Q000401:mortality*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate