Bypass surgery in elderly works fine

People over age 75 fare nearly as well during the years immediately after coronary artery bypass surgery as people roughly 15 years younger do, researchers in Japan report in the May Chest.

The researchers tracked the postoperative progress of 190 patients over 75 years old and 1,380 others under 75 years. The average age of people in the older group was 77 and in the other group, 62. People in both groups had sought care for various heart problems. All underwent coronary artery bypass surgery at Shin-Tokyo Hospital in Chiba.

Patients in the older group were more likely than those in the younger group to have complications from surgery—27 percent versus 14 percent. The older patients also were more prone to congestive heart failure during the follow-up period, which averaged 3 years, the researchers report.

However, the incidence of heart-related deaths in the two groups was similar. The researchers also found that the overall frequency of cardiac problems 1, 3, or 5 years after surgery didn’t differ significantly between the groups. Indeed, at least 88 percent of the older patients had no new cardiac problems during the follow-up period.

Many elderly cardiac patients and their spouses “are very anxious about the fate of patients after [bypass] surgery,” says study coauthor Hitoshi Hirose, a physician at Shin-Tokyo Hospital. Because of the new results, he says, “I believe more elderly people may go for the surgery.”

In bypass surgery, physicians typically use a vein taken from another part of the body and surgically attach it to the heart to reroute blood around a clogged coronary artery. How much blood can pass through the grafted vessel is a measure of the success of such operations. This measure didn’t differ significantly between the two groups in the study.