Background and methods: The incidence of coronary
artery bypass grafting (CABG) in elderly patients has been increasing.
We retrospectively analyzed the results of CABG performed at Shin-Tokyo
Hospital between January 1, 1991, and December 31, 1998. Preoperative,
perioperative, and follow-up data of patients ≥ 75 years old (group
E, n = 190) were collected, and compared with those of patients< 75 years old (group Y, n = 1,380).
Female gender, emergent CABG, preoperative balloon pumping use,
cardiogenic shock, hypertension, and preoperative cerebral vascular
accident were significantly more frequent in group E (p < 0.05).
CABG was completed without any significant differences, except for less
frequent use of the bilateral internal mammary artery (p < 0.01),
more frequent use of the saphenous vein (p < 0.005), and a greater
incidence of blood transfusion in group E (p < 0.0001). The
postoperative course required longer intubation, ICU stay, and
postoperative hospital stay in group E (p < 0.001), and was more
frequently associated with major complication (p < 0.0001) and
in-hospital death (p < 0.05). During the mean follow-up of 2.7 years
(maximum 6.9 years), the actuarial 5-year survival of groups E and Y
were 84.3% and 92.5% (p < 0.01), respectively, excluding
in-hospital mortality. The actuarial 5-year cardiac event-free rates
were 79.9% in group E and 79.7% in group Y, showing no significant
Conclusions: CABG in the elderly carries
certain surgical risks. However, the long-term cardiac event-free rate
after CABG in the elderly was almost the same as that of younger
patients. Inferior long-term survival in the elderly was most likely
due to the biological nature of aging.