Coronary artery bypass surgery in the elderly
B. A. Hibler, J. O. Wright, C. B. Wright, J. L. Ehrenhaft, D. B. Doty and N. P. Rossi
One hundred fifteen patients over 65 years of age were operated on at our
institution for coronary artery bypass grafting (CABG). The operative
mortality was 5% compared with an overall operative mortality of 2.5% in
the last five years for 1,500 persons with CABG. Increased risk factors
included qualification for New York Heart Association (NYHA) class IV,
ejection fraction of less than 35%, diffuse disease requiring more than
five grafts, and age over 75 years. At one year after operation, 81% of the
patients were clinically improved, and the survival rate was 91%. Patients
over 65 years of age in NYHA classes II and III with good left ventricular
function requiring four or less bypass grafts appeared to have an excellent
prognosis both acutely and during a one-year follow-up period.
