title: Do octogenarians benefit from coronary artery bypass surgery:  a question with a rapidly changing answer?
abstract: OBJECTIVE
  Octogenarians represent the fastest-growing segment of the population. Over 40% manifest cardiovascular disease, frequently in an advanced state requiring surgical revascularization. Increased mortality, morbidity, and expense in this high-risk group, with decreased longevity, present a growing challenge to our healthcare system.
  
  
  RESULTS
  Results of coronary artery bypass graft (CABG) surgery in octogenarians show a consistent pattern of improvement over time, with documented long-term survival and quality of life that rivals the age-matched population. Comparison with alternative therapies appears to be favorable. Clearer understanding of costs will provide a more rational context for treatment decisions. Increasing interest in the specific issues regarding frailty will help to guide the most appropriate patient selection.
  
  
  CONCLUSIONS
  Although it is clear that CABG surgery in octogenarians can be accomplished with increasingly good results, future research will need to focus on what specific surgical strategies are most appropriate for this elderly cohort; how the collaborative 'Heart Team' approach can be most effectively applied to determination of the most appropriate therapeutic course for these complex, frequently high-risk patients; what strategies can be applied to best manage and possibly reverse patient frailty; and what economic models most meaningfully inform clinical and public policy decision-making.
authors.affiliation: Florida Heart Research Institute, Miami, Florida, USA. doctorwu18@aol.com
authors.forename: Paul
authors.initials: P
authors.lastname: Kurlansky
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D016330:Frail Elderly; D006801:Humans; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States