Early and late results of coronary artery bypass grafting in the elderly

This study is a review of our experience with elderly patients, who have undergone coronary artery bypass grafting (CABG). Of 357 patients who underwent elective CABG from April 1982 to May 1986, 50 patients (14.0%) were 65 years old or older. The incidence of preoperative cardiac conditions in the elderly was almost the same as that in patients less than 65 years of age. The incidence of noncardiac preoperative conditions in the older patients, such as diabetes mellitus, renal dysfunction, concomitant malignant disease, atherosclerotic lesion of the ascending aorta, was significantly higher than that in the younger age group. Early surgical mortality was 4.0% (2 cases) in the older group, and 1.3% (4 cases) in the younger group. There was no significant difference in statistics. The incidence of major postoperative complications was not significantly different between the two age groups, except that of cerebral infarction, which was significantly higher in the elderly group (6.0% vs 0.3%, p less than 0.001). The rate of a long postoperative hospital stay was also significantly higher in the older group (43.8% vs 30.0%, p less than 0.05). Long-term results, such as late mortality, symptom-free rate and graft patency, showed no significant differences between the two age groups. It is concluded that CABG can be performed in selected older patients with relatively low mortality and morbidity. Special attention should be paid to prevent perioperative cerebral infarction.