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Ann Thorac Surg 1995;60:875-876
© 1995 The Society of Thoracic Surgeons

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Editorials

Coronary Operations in Octogenarians: Can We Select the Patients?

Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia

The first 20% of the full text of this article appears below.

The populations of the United States and other industrialized countries are aging, and the fastest growing population in the United States is the group more than 85 years of age. In the current era of health care reform, which is a euphemism for concern about costs, the ability to provide appropriate care for patients more than 80 years old at an acceptable cost is a major individual human as well as societal concern. As the most common major operation in the United States, at more than 300,000 performed annually [1], the use of coronary artery bypass grafting in the elderly is quite naturally a major issue. At present there are no randomized clinical trials that specifically address coronary operations in the elderly, and it seems unlikely that one can, should, or will be mounted. Thus, we are left with clinical series, as those found in this issue of The Annals.

The series by Cane and associates [2] and Williams and colleagues [3] add significantly to our understanding of coronary operations in patients more than 80 years of age. In the former series 121 patients (mean age, 82 years; 69% with isolated coronary bypass) underwent operation between 1982 and 1991. In-hospital mortality was 9.1%. Survival at 4.5 years was approximately 55%, which was identical to a sex-, race-, and age-matched control population. In the latter series, 300 patients (mean age, 81 years) underwent bypass grafting . . . [Full Text of this Article]

Related Article

CABG in Octogenarians: Early and Late Events and Actuarial Survival in Comparison With a Matched Population

Michael E. Cane, Chao Chen, Bridget M. Bailey, Javier Fernandez, Glenn W. Laub, William A. Anderson, and Lynn B. McGrath
Ann. Thorac. Surg. 1995 60: 1033-1037. [Abstract] [Full Text]

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				A. P. C. Yim, A. A Arifi, and S. Wan Coronary Artery Bypass Grafting in the Elderly : The Challenge and the Opportunity Chest, May 1, 2000; 117(5): 1220 - 1221. [Full Text] [PDF]