Coronary angioplasty in octogenarians: Comparisons to coronary bypass surgery

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Abstract
Coronary angioplasty was performed in 74 patients 80 years of age and older (mean 83±3). Single vessel coronary disease was present in 34% and multivessel coronary disease in 66%. Angioplasty of a single vessel was performed in 51 patients (69%), while 23 (31%) had angioplasty of multiple vessels.Angioplasty was successful in 59 of 74 patients (80%). Angioplasty was unsuccessful but uncomplicated in 12 (16%) due to (unyielding) calcified lesions or (impassable) old occlusions. Of these 12, 8 were discharged on medical therapy and 4 underwent elective uncomplicated bypass surgery prior to discharge. Three (4%) patients required emergency coronary bypass surgery due to abrupt vessel closure during the angioplasty procedure, with one hospital death (1.4%).Follow‐up (mean 24±22 months) was obtained in all patients. Of the 59 successful angioplasty patients, late mortality was 10% (cardiac 7% and non‐cardiac 3%). Survival and survival without myocardial infarction were both 90%; survival without either infarction or bypass surgery was 86%. Actuarial 3‐year survival was 91% and 3‐year freedom from death, infarction or bypass surgery was 87% by life‐table analysis. Repeat angioplasty for restenosis was performed in 7 patients (12%) without complications.

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