Coronary artery bypass grafting in the elderly

Background ann methods: The incidence of coronary artery bypass grafting (C ABG) in elderly patients has been increasing. We retrospectively analyzed t he results of CABG performed at Shin-Tokyo Hospital between January 1, 1991 , and December 31, 1998, Preoperative, perioperative, and follow-up data of patients greater than or equal to 75 years old (group E, n = 190) were col lected, and compared with those of patients < 75 years old (group Y, n = 1, 380), Results: Female gender, emergent CABG, preoperative balloon pumping use, ca rdiogenic shock, hypertension, and preoperative cerebral vascular accident were significantly more frequent in group E (p < 0,05). CABG was completed without any significant differences, except for less frequent use of the bi lateral internal mammary artery (p < 0,01), more frequent use of the saphen ous vein (p < 0,005), and a greater incidence of blood transfusion in group E (p < 0,0001), The postoperative course required longer intubation, ICU s tay, and postoperative hospital stay in group E (p < 0,001), and was more f requently associated with major complication (p < 0.0001) and in-hospital d eath (p < 0,05), During the mean follow-up of 2.7 years (maximum 6,9 years) , the actuarial 5-year survival of groups E and Y were 84.3% and 92.5% (p < 0.01), respectively, excluding in-hospital mortality. The actuarial 5-year cardiac event-free rates were 79.9% in group E and 79.7% in group Y, showi ng no significant difference. Conclusions: CABG in the elderly carries certain surgical risks. However, t he long-term cardiac event-free rate after CABG in the elderly was almost t he same as that of younger patients. Inferior long-term survival in the eld erly was most likely due to the biological nature of aging.