Early and Late Results Following Coronary Bypass Surgery Beyond the Age of 75 Years

Abstract

The indication for coronary bypass surgery in the elderly has been dramatically expanded in recent years. The results, however, are often contradictory. 1,538 consecutive patients undergoing cardiac surgery were divided into two groups by their age at the time of operation: younger than 75 years (n = 1,480) and 75 years and older (n = 58). These groups were compared with regard to influencing factors of early and late mortality, morbidity, and quality of life. Preoperatively, the clinical condition of the group greater than or equal to 75 years was significantly worse than the condition of the group less than 75 years (NYHA IV: greater than or equal to 75 years: 63.8%; less than 75 years: 31.9%). Cerebrovascular diseases occurred more often in the patients greater than or equal to 75 years (stroke or transient ischemic attack: greater than or equal to 75 years: 8.6%; less than 75 years: 2.3%). The necessity of carotid reconstruction prior to coronary surgery was significantly higher in the patients greater than or equal to 75 years: (greater than or equal to 75 years: 5.2%; less than 75 years: 1.5%). Diabetes mellitus could be observed in 19.0% of the patients greater than or equal to 75 years and in 10.1% of the patients less than 75 years. The preoperative ejection fraction was similar in both groups. Cardiopulmonary bypass time and crossclamping time of the aorta did not differ significantly. Both groups received approximately the same number of distal coronary anastomoses. Rethoracotomy due to hemorrhage had been observed more often in the older group (greater than or equal to 75 years: 8.6%; less than 75 years: 4.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Factors Influencing Health‐Related Quality of Life in Cardiac Rehabilitation Patients

“…About 55% of all acute myocardial infarctions occur in the Medicare age group—that is, those over the age of 65 years 4 . Several studies found that younger (<65 years) and older (=65 years) patients report similar HRQL following cardiovascular surgery 15–17 . Yet other studies have shown that older age is associated with impaired HRQL in patients with CAD 18 and diabetes 19,20 .…”

Yaşlilarda Koroner Arter Cerrahi̇si̇

“…Çeşitli yayınlarda hastane mortalitesi %5.2-9.3 arasında değişmektedir (1,(3)(4)(5)(8)(9)(10). Yaşlı hastalarda yaygın arterioskleroz sık olduğun-dan operasyon esnasında perfüzyon basıncı yüksek tutulmamalı, 80-90 mmHg'nin altına düşürülmemelidir (12).…”

“…Bu yayınlarda yaşlılık için kriter 60-80 yaş arasında değişmektedir. Koroner bypass ameliyatlarının morbidite ve mortalite oranlarının yaş-lı hastalarda gençlere göre daha yüksek olduğu ifade edilmekledir (3,5,6,7). Bu çalışmada yaşlılık sınırı 65 yaş kabul edilerek, kliniğimizde koroner bypass ameliyatı yapılan 45 olgu retrospektif olarak gözden geçi-rildi.…”

Comparison of Coronary Artery Bypass Surgery Results in Patients under 40 and over 80

“…Multiple risk factors for atherosclerosis are established in CAD patients manifesting with myocardial infarction such as smoking [4] [5], family history [4]- [7], hypercholesteremia [5] [6], diabetes mellitus [4] [7], hypertension [4]- [6], obesity [5] [7], oral contraceptive utilisation in young females [8], cocain addiction [9], etc. Higher mortality and morbidity rates of coronary artery bypass surgery procedures in the elder patients is a matter of common knowledge in literatüre [10] [11]. We aimed to discuss preoperative risk factors and early postoperative results of 128 patients under 40 and over 80 years age executed coronary artery bypass surgery in our clinic under demographic values retrospectively.…”