Seoul St. Mary's Hospital successfully operates on 91-year-old heart attack patient

Seoul St. Mary's Hospital of the Catholic University of Korea announced Friday that a patient in his 90s with a myocardial infarction was successfully operated on and discharged after being transferred through an emergency referral network linking regional hospitals and major medical centers.

A surgical team led by Kim Yong-han, a professor in the cardiovascular and thoracic surgery department at the hospital's Heart and Vascular Hospital, received the elderly patient, performed emergency cardiac surgery and managed an arrhythmia discovered during recovery before discharging him.

The patient, identified only by his family name Jeon, is listed as 87 in official records, but his family said he is in fact 91. He was diagnosed with a myocardial infarction at a hospital in Gyeonggi Province in late July, but severe calcification of the coronary arteries made catheter-based intervention impossible, requiring surgical treatment instead.

His advanced age and underlying conditions made surgery under general anesthesia a significant risk. The regional hospital contacted Seoul St. Mary's through an emergency hotline to request surgical care, and the patient was transferred to the tertiary medical center.

Immediately after the transfer, Kim consulted with the patient's family to confirm his actual age and overall health before discussing whether to proceed with surgery. The team then conducted a comprehensive assessment of cardiac function and general health, ultimately deciding to operate.

Given the patient's age and limited physical reserves, the team performed an off-pump coronary artery bypass graft (CABG) — a technique that does not require stopping the heart. The procedure, which rerouted blood flow around the blocked coronary arteries, was completed in about three hours.

The off-pump method allows surgeons to operate on a beating heart without a cardiopulmonary bypass machine, avoiding the systemic stress of extracorporeal circulation. It is commonly used for elderly patients and those with multiple comorbidities.

Electrocardiogram monitoring before and after surgery revealed atrioventricular (AV) block, a condition in which electrical signals fail to travel normally from the atria to the ventricles. To maintain a stable heart rhythm, the team also implanted a dual-chamber permanent pacemaker.

During recovery, the team continuously monitored chest imaging and heart rhythm and adjusted the pacemaker settings as needed. The patient recovered without complications and was discharged with his family.

The case highlights the importance of rapid coordination between regional hospitals and major medical centers in treating emergency cardiac conditions — and demonstrates that age alone should not rule out surgery. What matters, the hospital said, is a thorough assessment of overall health and a referral system capable of connecting patients to surgical care without delay.

The patient's family said they had been anxious about the need for cardiac surgery given his history of cerebral hemorrhage and the additional diagnosis of arrhythmia. "We were relieved that, thanks to cooperation between the hospitals, he was able to receive the necessary treatment quickly," the family said. "It was not easy to decide on surgery at his age, but after hearing the medical team's explanation we were able to make the decision — and seeing how quickly he recovered afterward, we feel it was the right choice."

"This case is the result of the regional hospital quickly recognizing a critical situation and making the referral in time, preserving the golden hour through the medical referral system," Kim said. "Cardiovascular disease often strikes without warning, and we will continue to do our utmost to save precious lives by building on this kind of cooperative framework."