［原著］80歳以上超高齢者に対する冠動脈バイパス手術の検討

概要

論文の詳細を見る
In recent years, an increasing number of coronary artery bypass grafting (CABG) has been performed on elderly patients. In our Department of Cardiovascular Surgery, 17 octogenarians underwent an CABG between November 1997 and September 2005. Patients consisted of six males and 11 females with a mean age of $83.0 \pm 1.9$ years, ranging from 80 to 86 years. In 15 patients (88.3%) , the diseased coronary artery was either in the left main trunk or the triple vessels. The underlying ischemic heart disease was acute myocardial infarction in three patients and unstable angina in 11 patients. The rate of emergent and urgent CABG was 41.2%. CABG was performed with cardiopulmonary bypass in four patients and with off-pump CABG (OPCAB) in the remaining 13 patients. The mean number of grafts was $2.0\pm0.7$ . Hospital mortality was O% with elective CABG and 42.9% with emergent CABG. Overall hospital mortality was 17.6%. Long-term mortality was 14.3% (2/14 cases) and five-year survival rate was 75.5% Given the high rate of hospital mortality with emergent CABGs, we conclude that CABG should be performed prior to a full unstable angina or acute myocardial infarction for patients over 80 years-of-age.