Background. With the steady increase in the number of elderly patients requ
iring coronary artery bypass grafting (CABG), scepticism still exists as to
whether this operationi is justified in older patients or not, and whether
there is an upper age limit. The aim of this study was to examine the effe
cts of increasing age on the outcome of CABG.
Methods. A retrospective review was performed on 2127 consecutive patients
undergoing primary CABG from January 1990 through June 1996. The patients w
ere arbitrarily divided into age groups: 69 years or less (n = 1607), 70-75
years (n = 371), 76-80 years (n = 129) and older than 80 years (n = 20). M
ortality, morbidity and long-term survival for each group was compared.
Results. The groups containing the elderly patients showed an over-represen
tation of women, as well as a higher frequency of arterial hypertension, hy
perlipidemia, previous infarction and diabetes. More patients, amongst the
elderly, had unstable angina and diffuse coronary disease requiring urgent
surgery and coronary thrombendarterectomy compared to those <70 years. Hosp
ital mortality did not differ between the groups, 1.8, 3.0, 2.3 and 5.0%. T
here was an increased incidence of low postoperative cardiac output and a h
igher incidence of gastro-intestinal complications amongst the elderly. The
5-year survival was 92.2% (<70 years), 87.0% (70-75 years) and 86.3% (76-8
0 years) and the cardiac event-free survival was 87.5% (<70 years), 78.4% (
70-75 years) and 80.8% (76-80 years) at 5 years.
Conclusions. An acceptable early mortality and medium-term survival(5 years
) together with excellent functional medium-term results support the justif
ication of primary CABG in older patients Irrespective of age.