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Coronary artery bypass surgery in elderly people

¹ School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
² St Helier Hospital, Carshalton, Surrey, UK
³ Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK

Correspondence to:
Correspondence to:
Dr A Natarajan
School of Clinical Medical Sciences, Newcastle University, 4th Floor, Illiam Leech Building, Framlington Place, Newcastle upon Tyne NE2 4HH, UK; arun.natarajan1{at}newcastle.ac.uk

An increasing number of elderly individuals are now undergoing coronary artery bypass surgery. Elderly patients, compared with patients of a younger age group, present for surgery with a greater burden of risk factors and reduced functional levels. Short-term outcomes are hence poorer in them. But symptom relief occurs in most survivors and is accompanied by excellent rates of long-term survival and a good quality of life. Therefore, an individualised risk–benefit profile must be carefully constructed by clinicians, taking into account several different factors and not just age alone. This review summarises the current concepts of coronary artery bypass surgery from the perspective of the very old.

Abbreviations: CABG, coronary artery bypass grafting; LAD, left anterior descending; LMS, left main stem; LVEF, left ventricular ejection fraction; OPCAB, off-pump coronary artery bypass surgery; SIRS, systemic inflammatory response syndrome