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CONTRAINDICATIONS

There are no absolute contraindications to CABG, but multiple factors may predispose a patient to a poor outcome. These factors must be weighed to determine the appropriateness of surgical revascularization versus less invasive procedures. Whereas advanced age is not a contraindication to surgery, it is well known that mortality is higher in elderly patients. Older patients have increased organ system disease. At the Mayo Clinic,[90] 159 patients older than 80 years undergoing CABG had an overall mortality rate of 10%. In patients without other organ system disease, the mortality rate was 4%, and 5-year survival was 80%. In a study of nearly 12,000 patients older than 60 years, Craver and associates[91]found that operative mortality for CABG was significantly higher among patients 80 years and older (9.1%) compared with patients in the age group 60 to 69 years (3.4%). The frequency of stroke rose from 2.6% at age 60 to 69 years, to 4.7% at 70 to 79 years, to 5.7% in …