Temporal trends in length of stay, discharge disposition, and long-term mortality outcomes were examined in nonagenarians who underwent coronary artery bypass grafting (CABG) from 1993 to 1999. A total of 4,224 fee-for-service Medicare beneficiaries (2,068 women, 2,156 men) aged>or=90 years underwent CABG from 1993 to 1999. The number of procedures increased from 325 in 1993 to 883 in 1999 among all fee-for-service Medicare patients aged>or=65 years. Approximately half of CABG procedures were performed on women each year. The mean length of stay decreased from 18.0+/-10.8 to 13.3+/-8.8 days from 1993 to 1999 but remained longer for women (p<0.001). A greater percentage of women than men were discharged to skilled nursing facilities. The overall crude mortality rates remained relatively stable at 13.5% at 30 days and 59.0% at 5 years. Men and women had comparable short-term mortality outcomes, but men had higher mortality rates for 2- to 5-year outcomes. In conclusion, the number of CABG procedures in nonagenarians is increasing, with a substantial portion attaining survivorship that is equivalent to projected life expectancy.