Mukai S, Murata H, Ueda T, Kita K, Lee S
Department of Cardiovascular Surgery, Kansai Rousai Hospital, Hyogo, Japan.
Kyobu Geka. 1997 Jul;50(8 Suppl):653-5.
Coronary artery bypass grafting (CABG) in elderly patients was increasing in recent years. Between January 1989, and December 1996, 11 patients aged 80 years or older (mean 81) underwent CABG in our hospital. Nine patients (82%) were in New York Heart Association class III or IV. Emergency surgery was required in 4 patients (36%). Incidence of emergency surgery is higher than younger patients (p < 0.005), emergency surgery required 7.7% (46/592) in younger patients. The operative mortality was 27% for these 80 years or older. It was one in elective cases and two of four (50%) in emergency cases. One operative death in elective cases was concomitant operation with arch aneurysm. More patients of CABG operations in octogenarians required emergency surgery, and emergency surgery is high operative mortality. Thus CABG in octogenarians should be performed earlier, not be denied because of age alone.
近年来，老年患者的冠状动脉旁路移植术（CABG）数量不断增加。1989年1月至1996年12月期间，我院有11例80岁及以上（平均81岁）的患者接受了CABG手术。9例患者（82%）属于纽约心脏协会III或IV级。4例患者（36%）需要进行急诊手术。急诊手术的发生率高于年轻患者（p<0.005），年轻患者中急诊手术的需求率为7.7%（46/592）。这些80岁及以上患者的手术死亡率为27%。择期手术中有1例死亡，急诊手术中有4例中的2例（50%）死亡。择期手术中的1例死亡病例是与主动脉弓瘤同时进行的手术。八十多岁患者进行CABG手术时，需要急诊手术的患者更多，且急诊手术的手术死亡率较高。因此，八十多岁患者的CABG手术应尽早进行，不应仅因年龄而被拒绝。
