Coronary Artery Bypass Graft Surgery in the Elderly

As a result of a rapidly ageing population and increasing incidence of coronary artery disease (CAD), the demand for coronary artery bypass graft surgery (CABG) in the elderly is growing. Almost 25% of all patients undergoing CABG are >70 years of age.1 Contemporary studies focus on health-related quality of life (HRQOL) following CABG, which is a key measure of operative success in the elderly. However, HRQOL outcomes remain unclear.This review provides an evidence-based overview of the HRQOL data from the literature in elderly patients undergoing CABG. To identify HRQOL outcomes, a literature search was conducted in August 2012 on PubMed by using the medical subject headings terms (MeSH) “Cardiac Surgical Procedures” and “Coronary Artery Bypass” and “Quality of Life” and “Elderly,” not “Angioplasty, Transluminal, Percutaneous Coronary” not “Heart Defects, Congenital” not “Heart Transplantation.” A manual search of EMBASE, DISCOVERY, and MEDLINE, and bibliographies of included studies, as well, was also conducted to identify any other studies not retrieved by the initial search. We identified 18 studies published in English since the year 2000 (Figure).2–19Figure. Search algorithm.2–19 HRQOL indicates health-related quality of life.According to the United Nations Population Division, the world’s population is ageing at a rapid and unprecedented rate. Within developed countries, the proportion of people >60 years of age is projected to double from 11% to 22% by 2050, constituting 2 billion people.20 In this time period, the number of very elderly people >80 years of age is projected to increase by a factor of 26 in comparison with a factor of 3.7 for overall world population.20 Recent data from the American Heart Association’s Heart Disease and Stroke 2012 Update shows >16 million American adults have CAD with a prevalence exceeding 80% in those >80 years of …