Tuesday, November 11, 2008

Coronary Bypass Surgery in the aged is now very successful


An AP story by Mary Marchione today (printed on A23 of the Nov. 11 New York Times) reports that patients in their 80s are typically surviving open heart surgery, including coronary bypass surgery and valve replacement, for at least six years, as long as people who did not need surgery. The link is here.

The American Heart Association held a conference in New Orleans Sunday and presented studies by Paul A. Kurlansky from Mount Sinai Medical Center in Miami Beach, and by Donald S. Litosky at Dartmouth.

Some patients now have coronary bypass surgery at an age as late as 90. The viability of late age surgery has been a rapid development in the past fifteen years. This is a major reason for rapidly increasing life spans, now demographically and economically significant. It used to be unusual to attempt bypass surgery past the mid 70s.

Bypass surgery has become more publicly known since David Letterman joined the “zipper club” in 2000 with emergency surgery. Sometimes bypass surgery is performed laproscopically with little invasion. But usually it requires a heart-lung machine and extensive and carefully managed recovery period to prevent injury to the area, often with time in a skilled nursing facility (which Medicare does pay for, up to certain limits). Personnel in SNF’s are often not as careful as necessary with certain risks as they need to be without the involvement of immediate family.

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