[Coronary artery bypass grafting in patients over 70 years old].
We examined the outcome of CABG in 157 patients aged over 70 years. The average age was 72.7 +/- 2.4 years: the number of the diseased vessels, 2.5 +/- 0.7/pt; the mean preoperative LVEF, 0.55 +/- 0.17 and the number of patients with left main trunk disease, 40 (26%). The mean number of bypass grafts was 2.8 +/- 0.8/pt. In 131 patients (83.4), left internal thoracic artery (LITA) was used to bypass the left anterior descending artery (LAD). The postoperative hospital mortality rate was 6.4%. After 10 years of follow-up, the actuarial survival rate and cardiac event-free rate were 73.6% and 88.9%, respectively calculated by the Kaplan-Meier method. A comparison of the long-term results of CABG with and without ITA grafting, showed no statistical difference with respect to actuarial survival rate. However, the cardiac event-free rate was improved by using an ITA graft (92.4% with an ITA vs 77.3% without an ITA, p = 0.047). This result suggested that the use of ITA in patients over 70 years old reduced the incidence of postoperative cardiac events without increasing the operative risk.
Kawata
T
T
Department of Surgery III, Nara Medical University, Japan.
Kitamura
S
S
Taniguchi
S
S
Kobayashi
S
S
Mizuguchi
K
K
Nishioka
H
H
Kameda
Y
Y
Niwaya
K
K
Tsuji
T
T
Tabayashi
N
N
D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D013895:Thoracic Arteries / Q000637:transplantation; D016896:Treatment Outcome