CABG In Elderly - The AFIC Experience

Abstract

Introduction:
Coronary artery bypass graft surgery in elderly population has been viewed with skepticism in past. Most studies have been reporting an increased morb idity and mortality in elderly population undergoing CABG surgery ranging from 3.5% to as high as 22%’. With increasing mean population age, rising incidence of coronary artery disease and greater availability of cardiac surgery facilities to our population, more and more old people are coming to, and are being accepted for sugery.

Patients & Methods:
We retrospectively studied records of all patients above the age of 70 years, operated at Armed Forces Institute of Cardiology between 1982 & 1997. A total of 50 cases were identified and all of their available clinical data was analyzed.

Results :
Our population consisted of 50 patients, 98% males; with a mean age of 71.72 years and a standard deviation of 1.75. of them, 36% were known diabet ics, 26% had deranged renal function, 8% had lung function impairment and 10% had other associated diseases.

Discussion:
Increased morbidity and early mortality after CABG surgery in elderly is well documented in almost all reported series, though the exact reasons are not clear. Of all the known or suspected factors contributing to high mortality after CABG in elderly, age itself has been most consistently incriminated. The

Conclusion:
CABG surgery in elderly, though associated with a modestly higher mortality, has an acceptable risk benefit ratio in properly selected patients. A symptomatic patient, who has no other therapeutic option should not be denied of potential benefits of surgery solely because of his age. As far as possible it should be performed as an elective procedure after careful preparation of the patient, in which instance, the results may be comparable to younger patients.