After he suffered a heart attack in May, Badruddin Khan, a resident of Azamgarh in Uttar Pradesh, came to Mumbai for treatment.
Tests showed Khan had four coronary blocks, each almost 100 per cent, and a coronary bypass surgery was his only hope. In June, Khan underwent four bypass surgeries at Fortis Hospital, Mulund, and was out of the hospital within five days.
Khan’s case may sound routine, except that he is 88 years old. Medical advances are giving doctors the confidence to conduct invasive surgeries on the elderly, who traditionally fall in the high-risk category for procedures such as coronary bypass surgery. “I was worried about the risks of a bypass surgery for my father. But doctors assured us he was fit for it,” said Khan’s son, Nauman (54).
“I get five to seven patients in the 70 to 80 age group every week for bypass surgery and one above 80 years every two weeks,” said Dr Kaushal Pandey, cardiac surgeon, Fortis Hospital.
Cardiologists look at a patient’s health and fitness levels and not just his or her age before deeming them fit for surgery. “Some 70-year-olds often look like 90-year-olds and vice versa. The oldest person I did a bypass surgery on was a healthy 92-year-old,” said Dr Ramakant Panda, vice-chairman and cardiovascular thoracic surgeon, Asian Heart Institute.
There are several age-related health risks that cardiologists must rule out before deciding that an elderly patient is fit for a complicated cardiac surgery.
“Older patients take longer to recover post-surgery as their organ functions have deteriorated. We conduct tests to check if their brain, kidney and liver functions are good enough to recover from the operation. They shouldn’t have co-morbid conditions such as diabetes or acute blood pressure,” said Panda.
Even a relatively risk-free procedure such as an angioplasty, which widens a narrow or blocked blood vessel by using a balloon catheter sent in through a blood vessel in the thigh or hand, can create complications.
“Blood vessels in older people are hardened, which make it difficult to negotiate blocks with balloons. But in expert hands, an angioplasty is safer than a bypass above the age of 80,” said Dr Dayanand Kumbla, interventional cardiologist, Jupiter Hospital.