Coronary artery bypass grafting for octogenarians: experience in a private hospital and review of the literature.
METHODS
Indications for coronary artery bypass grafting (CABG) are expanding. We retrospectively analyzed the results of isolated CABG performed at Shin-Tokyo Hospital between January 1, 1992, and August 31, 2000. Preoperative, perioperative, and follow-up data of patients 80 years of age or older (group E, n=55) were collected and compared with those of patients between 75 and 79 years of age (group Y, n=197).


RESULTS
Patient demographics were not significantly different except there was a greater incidence of co-existing valvular disease in group E. CABG was completed without any significant differences, except fewer distal anastomoses and more frequent off-pump CABG were performed in group E than in group Y. The in-hospital mortality rates of group E and Y were 1.8% and 2.5%, respectively (p=NS). The postoperative recovery (intubation time, ICU stay, and postoperative hospital stay) of group E was similar to group Y. During the mean follow-up of 2.6 years (maximum 8.4 years), the actuarial 3-year survival of groups E and Y was 84.5% and 94.9% (p=NS), respectively, excluding in-hospital mortality. The actuarial 3-year cardiac event-free rates were 100% in group E and 88.4% in group Y (p=NS).


CONCLUSIONS
CABG for octogenarians can be performed safely. Once adequate revascularization was established, the long-term cardiac events were similar to those of the younger patients.
Hirose
H
H
Department of Cardiovascular Surgery, Kobari General Hospital, Noda City, Chiba, Japan.
Amano
A
A
Takahashi
A
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D016304:Hospitals, Private; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests; D012307:Risk Factors; D016019:Survival Analysis; D013995:Time; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology