CORONARY ARTERY BYPASS SURGERY IN ELDERLY PEOPLE A INSTITUTIONAL RETROSPECTIVE STUDY

Objective: To Study the prognosis and outcome in elderly people present with coronary artery disease under going coronary artery bypass surgery in our institute. Methods: 134 elderly patient who are 65 years and more than 65 years who underwent coronary artery bypass surgery between January 2017 to December 2022 who's datas are collected from our computer stored data and from medical record department in our college and from Tamilnadu chief minister comprehensive health insurance scheme institutional Web site data base. Results: 1184 cases of coronary artery bypass surgery done in our institute from January 2017 to December 2022 from this 134(11.3%) cases are elderly patient, mean age 67. 6 years (range 65-75 years) highest of 85 years old female operated in this period. The indication for surgery was triple vessel disease in 65 patient(48.5%) ,double vessel disease in 40 patient(29.8%),single vessel disease in 5 patient, single vessel disease with ventricular septal rupture in 1 patient, left main coronary artery stenosis in 44 patient(32.8%),12 patient with post coronary stent. Surgical procedure Off pump coronary artery bypass surgery in 108 patient(81%), On pump beating heart coronary artery bypass surgery in 5 patient (3.7%),On pump arrested heart coronary artery bypass surgery in 6 patient(5.35%) with mitral mitral mechanical valve replacement in 1patient, with aortic mechanical valve replacement in 4 patient. A total of 320 grafts were constructed(mean 2.4 grafts per patient),35 (26%) of them being arterial only left internal mammary artery harvested and other grafts were great saphenous vein. Post operative average ventilation time18hrs (range 18hrs to 24hrs), There were 21(15.7%)hospital death and 15(11%) late death in follow up, total 36 (26.8%) death till now. Conclusion: intra operative, post operative mortality and morbidity is high in patient present with severe left ventricular dysfunction, coronary artery diseases induced complication and additional comorbidity, however most of patient recovered from post operative cardiovascular lethal or morbid event and on regular clinical follow up