Coronary artery bypass surgery in the septuagenarian.

Analyzed during a 3-year period were 86 patients from 70 to 80 years of age who underwent coronary artery bypass grafting without other cardiac procedures. The series included 57 men (66%) and 29 women (34%). The average follow-up period was 27 months. The early mortality rate for the men was 5.2%, and the overall mortality was 8.7%. This compared with an age-adjusted nationally expected death rate of 12.1% for this age group during this period of time. The early mortality rate for the women was 6.9%, with an overall mortality rate of 13.9%. This compared with an 8.7% age-adjusted nationally expected death rate. Factors which did not affect mortality in this particular series included smoking, hypertension, diabetes, and ejection fraction. Factors which did affect mortality included peripheral vascular disease (29% mortality), and postoperative complications (38% mortality). Of the 86 patients operated on from 1978 through 1980, ages 70 to 80, 88% are alive (76 of 86 patients). Of the patients living, 60.5% have no chest pain, and 26.3% describe their chest pain as significantly improved. When medical treatment alone fails, coronary artery bypass grafting is possible in the older age group to relieve disabling angina and improve the quality of life, with very acceptable mortality rates.