Turkish Journal of
GERIATRICS

Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliğini, ANKARA Coronary artery bypass surgery (CABG) may be the most suitable choice in between the unattractive alternatives for the diabetic and elderly patients. Although age is a well known mortality risk factor for the patients who underwent CABG, increasing number of patients are operated with an acceptable risks. This study is planed to investigate the risk factors for the diabetic patients and atherosclerotic lesion distribution due to age. Between 1986 and 2003, a total of 328 patients with diabetes mellitus were underwent CABG at Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. Of these patients, who were below the age 45, were considered as group 1 (161 patients) and who were above the age 70, were considered as group 2 (167 patients). 30.4 % of the patients in group 1 and 11.4 % of the patients in group 2 had one-vessel disease. Postoperative inotropic and mechanical support, vasodilator usage were higher in group 2. Low cardiac output was diagnosed in 3.1 % and 16 % in group 1 and 2 respectively. Postoperative myocardial infarction, major neurolojic events and infection were seldomly observed and all were included in group 2. The operation, cross-clamp and cardiopulmonary bypass time were longer in group 2. Hospital mortality were found as 1.2 % in group 1 (2 patients) and 16.8 % in group 2 (28 patients). Atheroscleroic lesion distribution was different accoring to different coronary arteries. Left main coronary artery disease was determined 5.6 % and 8.4 % in groups 1 and 2. Circumflex artery branches and right coronary artery lesions were differed according to groups and they were diffusely found in group 2. In conclusion, it is neccessary to agresively treat the diabetes and additional risk factors especially before the CABG. Keywords : Diabetes mellitus, Elderly, Coronary artery bypass grafting