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Coronary Artery Bypass Surgery in the Elderly: Experience of Tertiary Care Hospital

Cardiothoracic Surgery Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan

For reprint information contact: Shahid A Sami, FRCS Tel: 92 21 493 0051 Ext: 4704 Fax: 92 21 493 2095 Email: shahid.sami{at}aku.edu, Cardiothoracic Surgery Section, Department of Surgery, The Aga Khan University, PO Box 3500, Stadium Road, Karachi 74800, Pakistan.

In the subcontinent, improving life expectancy may increase the number of elderly patients requiring coronary artery bypass. The elderly have a higher risk of mortality, and cost vs benefit is presumed to be unrewarding, leading to a disinclination to operate on such patients. We reviewed the records of patients 70 years old undergoing coronary revascularization in a 10-year period. Between 1995 and 2004, 3,312 coronary bypass operations were performed, including 242 (7.3%) in patients 70 years. Of these, 207 (86%) were male, 73 (30%) had non-elective surgery, and 177 (73%) had a high-risk EuroSCORE. Early postoperative mortality was 8.7% (21/242), and 33 (13.6%) patients experienced morbidity. One-year follow-up of 106 (44%) patients was possible. There were 4 (1.7%) late deaths from noncardiac causes. Death, morbidity, and postoperative functional class were significantly associated with preoperative functional class. Meticulous selection of elderly patients for coronary artery bypass may help maximize the benefits of this surgery.

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