Recovery In The Elderly After Coronary Artery Bypass Surgery

Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of well-being and, therefore, the goal ofany socio-economic system. Until only a decade ago, medical opinion regarding how often coronary artery bypass surgery (CABG) was indicated or useful was unclear. Becauseof multi-organ senescence, the elderly were expected to have a higher rate operative morbidity and mortality and, having crossed an advanced life span, might not live very long after the operation. Decision making on medical grounds first depends on knowing if a patient can survive an operation compared to how long they would survive without it, i. e.

The aim of this textbook is to give guidance in prevention, lifestyle counselling and rehabilitation for cardiologists, other physicians and many different categories of health professionals in cardiac rehabilitation teams.

A study of coronary artery bypass graft (CABG) and off-pump coronary artery bypass graft patients.

CORONARY ARTERY BYPASS SURGERY IN ELDERLY PATIENTS: 20 YEARS OF EXPERIENCEP. Carmona*, E. Mateo**, A. Mena****Cardiac anesthesia-intensive care H. La Fe. Valencia. Spain, **Cardiac anesthesia-intensive care and ***Cardiac Surgery H. General. Valencia. SpainBackgroung: As increasing the age of patients undergoing cardiac surgery, the identification of main postoperative complications of this population and the evaluation of institutional outcomes is essential. We aim to describe our experience in CABG in elderly patients older than 80 years old comparing intraoperative and postoperative outcomes with younger population.Method: From January 1993 to June 2013, 3097 patients underwent consecutive emergency and scheduled CABG surgery. 1770 underwent on-pump CABG and 1327 off-pump CABG according to surgeonu00b4s criteria. Patients undergoing on-pump receiving other concomitant procedure and re-operations were excluded. Patients older than 80 years old were identified.Results. We identified 98 patients older than 80 years old (80-group) (mean age 82u00b13.5 years old) and 2957 younger than 80 years old (control group) (mean age 64.2u00b19.7 y.o.). Additive EuroSCORE was 8.4u00b14.8 and 4.6u00b14.6 (p

The 16th Edition of this classic text provides surgeons with the most comprehensive information available in this field. This exhaustive revision includes more than 1,500 illustrations and 1,800 of the most recent references available in surgery. Included are: advances in cardiothoracic surgery, neurosurgery, plastic and maxillofacial surgery, pediatric surgery, hand surgery, orthopedics, gynecology, and urology, as well as the historical and developmental aspects of surgical practice and the anatomical, pathological, physiological, biochemical and molecular basis of several disorders.

Abstract: Many things change following Coronary Artery Bypass Graft (CABG) surgery for both the patient and his/her carer. The major aim of this research was to provide an indepth examination of these changes to investigate influences on recovery. The study was devised on the premise that this information would provide a significant basis for hospital discharge planning.-- A qualitative research approach, naturalistic inquiry, guided the study. Sixty people were interviewed, including thirty patients and their carers. Interviews were undertaken four to five weeks following discharge from hospital after CABG surgery. Subsequently, twelve months after the initial interview, patients and carers were again contacted to verify the findings generated from the first phase of the study, and to gain further data on his/her current health status.-- Data analysis revealed a number of maj or themes and sub themes for patients and carers. Almost half the patients stated that heart surgery was a huge personal shock. Adjusting to life after surgery was difficult, and patients experienced some form of physical pain or change. An unexpected finding was the extent to which many of the patients were attuned to their post-operative physical adjustments. They spoke of mental and emotional changes as well as concerns over the financial burden of the surgery. Coming to terms with lifestyle adjustments and worrying about the future were other themes that emerged in patients' accounts. They offered suggestions to improve support services, like establishing a twenty-four hour telephone chat line and forming community clubs to link up with other patients. In assisting to better prepare for discharge home, they suggested providing more information about what to expect during recovery, like the up and down days that they might experience.-- Carers experienced a separate set of issues/needs and concerns as they came to terms with their loved one's cardiac surgical recovery. The major findings for carers fell under four major themes, Events Surrounding Another's Heart Surgery; Adjusting to the Surgery; Personal Changes Due to Surgery and Discovering Pathways to Recovery. Carers were shocked with the news that a family member required urgent cardiac surgery and theft reactions suggested a sequence of experiences that encountered in coming to terms with the event. Carers adjusted to the situation by taking on the role of watcher or minder and monitored the patient's recovery. Some of the personal changes that carers dealt with, were changes in their activities and responsibilities; tiredness; experiencing a range of emotions and wonying about the unknown. Carers also offered suggestions for improved support services, like identifying a range of community services in close locality to his/her home. In better preparing for discharge home, some carers wanted more assistance and advice on how to be an effective carer.-- This research study provides unique insights into the experiences of patients and carers after coronary bypass graft surgery in the first four to five weeks following discharge home from hospital. The study outlines the issues/concerns and needs of CABG patients and their carers after they leave hospital, highlighting those related to age, gender, and family support. For example, many patients commented that they were too young for this to occur. Gender differences included, that the majority of carers were females and male patients reported experiencing more pain following cardiac surgery. Family support was a critical factor in enhancing recovery. Study findings suggest the need for a re-examination of hospital discharge preparation and the further provision and monitoring of home support services.