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Doctors Performing More Bypass Surgeries on Patients in Their 80s

Aired May 5, 2000 - 1:38 p.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

NATALIE ALLEN, CNN ANCHOR: It's no secret older Americans are more active and generally healthier these days, and that has implications when doctors consider candidates for heart surgery.

CNN medical correspondent Elizabeth Cohen has that in today's health news.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): While in the hospital for bypass surgery, David Letterman heard about Israel Perlman (ph).

(BEGIN VIDEO CLIP, "LATE SHOW WITH DAVID LETTERMAN")

DAVID LETTERMAN, TALK SHOW HOST: In December, last December, our next guest underwent heart bypass surgery at the age of 92. It makes me feel like a sissy.

(END VIDEO CLIP)

COHEN: And Mr. Perlman's not a rarity anymore. In the United States, the number of bypass surgeries performed on people in their 80s increased 67 percent from 1987 to 1990.

Eighty-nine-year-old Elmer Jenkins had open-heart surgery two years ago. Now he holds down not just one, but two jobs.

ELMER JENKINS, HEART PATIENT: So I've been pretty lucky for an old coot.

UNIDENTIFIED FEMALE: Any twos, Grammy?

COHEN: Mary Schoeller had a heart valve replaced last year at the age of 90.

MARY SCHOELLER, HEART PATIENT: It was almost, really, unbelievable, but it was a miracle.

COHEN: Her surgeon explains why doctors aren't so scared anymore of doing cardiac surgery on older people.

DR. PAUL ADDONIZIO, CARDIAC SURGEON: Clinicians have begun to distinguish between chronological age and physiological age. So a patient perhaps in their 40s who has done very little to care for themselves may be much higher-risk than the patient in their 80s that has really taken care of themselves for 80 years.

COHEN: In general, however, heart surgery is riskier if you're older. If you're in your 80s, there's about an 8 percent chance you'll die from having the surgery. Younger people have only about a 3 percent chance of dying. Plus, elderly people are more likely to need lots of rehabilitation.

DR. KIM EAGLE, AMER. COLLEGE OF CARDIOLOGY: It may take six months, even a year for some of my patients to regain the kind of energy that they expected from the operation.

COHEN: So doctors say it's important to choose elderly patients carefully. Some are too ill, too fragile for open heart surgery, while others, like Mary Schoeller, are perfect candidates.

UNIDENTIFIED CHILDREN (singing): Yes, Jesus loves me, the Bible tells me so.

(END VIDEOTAPE)

ALLEN: Elizabeth is here with us now.

What great news.

COHEN: Absolutely.

ALLEN: Is this something insurance pays for?

COHEN: Well, you know it's interesting because doctors today complain that insurance gives them a hard time about paying for pretty much anything, but this does not appear to be the case in this situation. Doctors who we talked to said that insurance actually does pay for it, Medicare and private insurance, that the doctors are very careful about selecting who they do the surgery on.

For example, they don't do it on a 90-year-old who has all sorts of other problems and who, perhaps, doesn't have very long to live. They're selecting patients who are sturdy and hearty and who, as the doctor said in the story, might be just as healthy as a 40-year-old.

ALLEN: So that's good news for 90-year-olds who are healthier than 40-year-olds.

COHEN: That's right.

ALLEN: But the bad news is, no more free passes because they're doing so well.

COHEN: That's right. You can't ski, but you can have heart surgery. That's right.

ALLEN: Hopefully they'll still get the movie passes.

Elizabeth Cohen, thanks.

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