Reference no: EM133921698

Question

1. A 105-year-old male patient, who has a known cardiac disease for almost 5 years, was admitted to cardiology clinics when his complaints aggravated in the last week. Ejection fraction was 45% in echocardiography. Coronary angiography findings are as follows: 95% of stenosis in the left anterior descending (LAD) with plaques and lesions by 80%, and 70%-80% of stenosis in right coronary artery (RCA).

2. In the physical examination, arterial blood pressure was found to be 100/60 mmHg, and crepitation was also detected in the basal segments of the lungs after listening the chest. Blood analysis findings are as follows: urea 87 mg/dL, creatinine 1.7 mg/dL. The patient had pain at rest and 2-3 mm of elevation was seen at the anterior derivations, which was seen at the ECG. Our case had unstable pain, coronary lesions were not suitable for PTCA procedure, and there were pre-shock finding. Therefore we decided to go for semi-urgent CABG.

3. As in this case presentation, there are several modifications needed for the surgical strategy for advanced-age group since CABG operations are more risky.