Coronary artery bypass surgery in nonagenarians

As the number of nonagenarians increases yearly in the United States, surge ons will be asked more often to evaluate the possibility of intervention fo r coronary artery disease in this age group. The purpose of this study is t o document experience with patients 90 years of age or older in order to de termine whether coronary artery bypass grafting surgery is justified. Eleve n patients aged 90 years or more underwent cardiac surgery for symptomatic coronary artery disease refractory to medical management between January 1, 1987, and December 31, 1996. All patients were in NYHA Class IV preoperati vely. In-hospital death occurred in two patients (18%). In-hospital morbidi ty occurred in all patients (100%) including seven cardiac, four respirator y, two neurologic, and one infectious. All survivors left the hospital symp tomatically improved. The mean length of stay was 28 days. Four patients di ed at a mean of 2 years and 2 months postoperatively. Five patients remain alive at a mean of 1 year and 7 months. Coronary artery bypass grafting in nonagenarians can be performed successfully in selected cases. However, inc reased mortality and morbidity rates and length of stay are associated with this age group. For survivors, the quality of life is improved and the pro jected life expectancy restored.