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  • Title: [Surgical results of coronary artery bypass grafting in patients older than 75 years].
    Author: Kimura N, Urita R, Watanabe T, Kitano I, Murakami T.
    Journal: Kyobu Geka; 1997 Jul; 50(8 Suppl):656-9. PubMed ID: 9251488.
    Abstract:
    We studied 19 patients, all older than 75 years of age, who had isolated coronary artery bypass grafting (CABG) from January 1990 to December 1996. Clinical characteristics, hospital mortality and long-term survival were compared between this elderly group (> or = 75 years) and a younger group (60-74 years) in which 130 consecutive patients underwent the same procedure during the same period. There were no differences of coronary risk factors, renal function, respiratory function and ejection fraction between the two groups. The incidences of left main trunk stenosis (> or = 50%) and three-vessel-disease were more common in the elderly group, but the difference between the groups was not statistically significant. Preoperative use of an intra-aortic balloon pump was more frequent in the elderly group (p < 0.01). The hospital mortality rate of 31.6% for the elderly group was significantly higher than that of 5.4% for the younger group (p < 0.01). However, of particular note is that the 30-day hospital mortality was half (15.8%) and that three of six (50%) hospital deaths occurred between 35 and 148 days. These patients died from acute respiratory failure subsequent to aspiration pneumonia, ruptured dissecting aortic aneurysm, and ischemic enterocolitis. This difference between the 30-day hospital mortality rate (15.8%) and hospital mortality rate (31.6%) emphasizes the influence that postoperative complications can have on subsequent outcome. Of 136 hospital survivors (123 in the younger group and 13 in the elderly), 98% have been followed for a mean of 32 months. The 4-year survival was 60 +/- 22% for hospital survivors of the elderly group. It compares favorably with that for the younger group (85 +/- 5%), and with previously reported data. We conclude that despite a significantly increased hospital mortality, good long-term survival can be realized after CABG, even in patients older than 75 years.
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