Intractable Angina Pectoris in the 65 to 79 Year Age Group: A Surgical Approach

¹ Department of Medicine, Cardiology Division (Dr. Hamby) and Surgery, Cardiovascular Division (Drs. Wisoff, Kolker and Hartstein), Long Island Jewish-Hillside Medical Center, New Hyde Park, New York, Queens Hospital Center Affiliation, Jamaica, New York and the School of Medicine, Health Sciences Center, State University of New York at Stony Brook, Stony Brook New York

Twenty-six patients in an older age group (range 65-79) referred because of intractable angina pectoris revealed, with few exceptions, no significant differences in clinical features, hemodynamic and angiographic findings when compared to 150 younger patients (range 30-64) referred for similar reasons. The older patients were generally sicker because of physician delay in arriving at a decision for angiographic evaluation. The male-female ratio was lower in the older age group. The duration of angina pectoris and the extent of the coronary artery disease revealed no significant differences when comparing the older patients with the younger patients. Left ventricular function revealed no significant differences. Five patients were rejected for surgery because of diffuse coronary artery disease or poor left ventricular function. Two patients sustained acute myocardial infarctions while waiting for surgery and one died. Seventeen patients underwent aortocoronary bypass surgery and were compared with 100 patients less than 65 years of age who also underwent aortocoronary bypass surgery. The mortality rate (16 percent), postoperative course, length of stay in the hospital and immediate graft closure frequency (5 percent) were entirely comparable to results in the younger patients. Our experience indicates that the age of the patient should not be considered a factor in determining whether a patient should be evaluated for aortocoronary bypass surgery.