Isolated Coronary Artery Bypass Grafting in Patients 70 Years of Age and Older: Comparative Results in a 40-60 Years' Age Group

Coronary artery bypass grafting has been performed for elderly (?70 years) with increasing frequency. From May 1985 through October 1996, 223 elderly patients (Group I) underwent isolated coronary bypass grafting at Koşuyolu Heart and Research Hospital. The risk factors, morbidity and mortality results of Group I were compared to 200 CABG patients who had similar clinical features and were 40- 60 years of age (Group II). Group I consisted of 180 males, 43 females, mean age 73,8 years and Group II had 184 males, 36 females, mean age 55,5 years. The preoperative myocardial infarction (Ml) rate was 62%, severe left ventricular dysfunction (LVD) rate 33,6% (75 cases) in group I and 48% preoperative MI, 25% (55 cases) severe LVD in group II (p<0.05). The mean number of bypass grafts was 2;66 per patient in group I and 2,83 in group II. The internal mammary artery was used in 77,1% (172 cases) in group I versus 85,4% ( 188 cases) in group II (p<0.05). The rate of perioperative MI (7,6%; 5,9%), the usage of inotropic agents (21 %; 19% ), the insertion of intraaortic balloon pumping (IABP) (7 ,6%; 3,6%), the extracorporeal assist device {3,3%; 1,36%) were higher in group I than in group Il. In addition noncardiac complications were found higher in group I. The hospital mortality was 8,9% and Iate mortality during a mean follow-up of 4 years was 6,7%, total mortality was 15,6% in group I and 4,5%, 3,1% and 7 ,6%, respectively in group II (p<0.05). The follow-up time ranged from 6 months to ten years (mean 4 years). In conclusion, inspite of high mortality and morbidity risks, the necessity of CABG operations in the elder age group may be accepted for relief of ischemic symptoms and providing quality of life.