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Editor,—We read with interest the manuscript by Zaidi and coworkers who reported their experience on 575 patients aged 70 years and older, in whom various cardiac surgical procedures were performed.1 Their study, along with many others published in the literature in recent years,2-4 shows that the role of cardiac surgery in the elderly, and particularly coronary artery revascularisation, is still evolving. Despite refinements in the perioperative management of cardiac surgical patients, valve surgery as well as coronary artery revascularisation in the elderly continue to be associated with operative risks considerably greater than those observed in the younger population.2-4 In addition, older patients are at higher risk for developing devastating complications such as stroke, …