A SUCCESSFULLY OPERATED CASE OF ANGINA PECTORIS AND AORTIC INSUFFICIENCY IN AN ELDERLY PATIENT (78 yrs)

A 78-year-old man complaining of chest pain was admitted to a nearby hospital with a diagnosis of acute myocardial infarction on March 26 1992. After discharge chest pain recurred and the patient was re-admitted to the same hospital with a diagnosis of angina pectoris after infarction, where internal treatment failed to control the pain. He was transferred to the hospital. On admission his condition was grade N according to NYHA classification. Based on test data, physiological age, and quality of life of the patient, it was thought that he was a possible candidate for operation. Coronary angiogram showed 99% stenosis of the left anterior descending artery and 99% stenosis of the right coronary artery. Aortogram showed severe aortic insufficiency. Emergency surgery was carried out on combination of coronary arterial bypass grafting and replacement of the aortic valve. The postoperative course was uneventful. In decision-making of operative indication for aged patients, we should consider the physiological age rather than real age, and perform operation aggressively, if the indication is reasonable.