Piotr Okoński, Maciej Banach, Marcin Barylski, Robert Irzmański, Stanisław Ostrowski, Janusz Zasłonka
Med Sci Tech 2006; 47(2): RA71-74
Introduction. For the sake of permanent progress of medicine, methods of preservative treatment and intensive development of invasive cardiology, cardiac surgeons more and more often meet the problem of operation of patients over 75. Aim of the study. The aim of our study was the analysis of risk of complications occurrence and evaluation of mortality of direct heart revascularization in group of patients over 75 years old. Materials and methods. Between 1999-2003 59 patients, aged 75-84, were subjected to direct revascularization of heart. Coronary angiography was carried out in all patients before operation. The most commonindication for operation was three-vesseldisease.Results. Early mortality was 10,17% and the most often reasons of deat hwere: postoperative low output syndrome and renal failure. To the most common complications observed during study included: supraventricular and ventricular arrhythmia, low output syndrome, renal complication, intra- and postoperative cardiac infarct, pulmonary complication, rethoracotomy and neurological complications. Mean time of stay in intensive care unit was 3,39 days and mean time of hospitalization was 9,62 days. We showed significant correlation between coronary disease type, preoperative renal failure, intra- and postoperative heart infarct, necessity of using intraaortic contrapulsation, postoperative renal complications and death. Conclusions. Direct heart revascularization in patients over 75 years old is connected with large risk of death and postoperative complications. Before patients’ qualification,especiallywith many co-existent risk factors of postoperative complications appearance we should precisely evaluate risk and potential benefit of operation. Never the less it should be emphasized that in the postoperative period most patients experienced the significant reduction of symptoms of coronary artery disease.
Keywords: Mortality, Coronary Artery Disease, elderly patients, revascularization