[Isolated coronary surgery in the octogenarian. Immediate results and analysis of long-term survival rate and quality of life].
BACKGROUND
There are almost three million octogenarians living in France, many of whom present with a coronaropathy. Moreover, it appears that life expectancy at 80 years of age is still important.


OBJECTIVE
To evaluate the results of coronary surgery among these patients.


METHODS
Eighty-eight consecutive octogenarians who had an isolated coronary artery bypass surgery between 1996 and 2002 were compared with 165 patients 60 to 70 years of age; the two groups had been paired according to the main risk factors. Patients were contacted by telephone and then received a quality-of-life-related questionnaire.


RESULTS
Operative mortality was 2.3% in the octogenarian versus 1.2% in the 60- to 70-year-old group (P not significant). There was more low cardiac output syndrome, postoperative acute renal failure and transfusion in octogenarians. Long-term survival (average duration of follow-up was 3.8 years) was higher in the 60- to 70-year-old group: 89.7% versus 77.9% (P=0.025). Four independent risk factors of long-term increased mortality were found: age, diabetes, history of stroke and postoperative blood transfusion. Finally, the long-term survival in the octogenarians who had this surgery was higher than in the octogenarians of the general French population to a significant degree, with a quality of life considered to be satisfactory.


CONCLUSIONS
For selected octogenarians, an isolated coronary surgery can be proposed, with short- and long-term results comparable with those of a younger population.
Service de Chirurgie Cardiaque, Boulevard de Chantourne, Grenoble, France. vbach@chu-grenoble.fr
Vincent
V
Bach
Sophie
S
Tramaille
Olivier
O
Chavanon
Michel
M
Durand
Marianne
M
Noirclerc
Claire
C
Vesin
Paolo
P
Porcu
Rachid
R
Hacini
Gérald
G
Vanzetto
Jacques
J
Machecourt
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
Chirurgie coronaire isolée chez l'octogenaire: Résultats immédiats et analyse du taux de survie et de la qualité de vie à long terme.