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  • Title: [Aortocoronary bypass operation or percutaneous transluminal coronary dilatation in patients over 70 years of age?].
    Author: Slany J, Karnik R.
    Journal: Wien Med Wochenschr; 1993; 143(3-4):62-5. PubMed ID: 8506687.
    Abstract:
    On account of improved outcome an increasing number of patients more than 70 years old have undergone aortocoronary bypass grafting or percutaneous transluminal coronary angioplasty over the past years. Elective coronary bypass surgery carries a risk in the range of 5 to 10% hospital mortality among this age group. However, excellent long term results are in favour of surgery in carefully selected patients. Major indications are patients with extended areas of myocardial ischemia due to left main stem or proximal triple vessel disease. Overall results of PTCA are, likewise, somewhat less satisfactory in geriatric patients than in younger ones. With careful selection of patients, however, morbidity and mortality of this intervention is low. Excellent indications for PTCA are short, concentric, non calcified single or multiple vessel lesions in symptomatic patients with good ventricular function. In patients with angina refractory to medical treatment who carry an increased risk of surgery, PTCA may be worthwhile even if the coronary morphology is less promising (type B or C lesion).
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