Off-pump coronary artery bypass grafting in octogenarians.
OBJECTIVE
Off-pump coronary artery bypass grafting (CABG) has become accepted for myocardial revascularization because it reduces perioperative morbidity. We assessed the safety and efficacy of bypass surgery on the beating heart in elderly patients.


METHODS
Off-pump CABG was done in 25 patients aged 80 years or older between February 1996 and February 2001. We retrospectively compared clinical results for these patients to those of 18 consecutive age-matched patients undergoing on-pump CABG during the same period.


RESULTS
Mean patient age in both groups was similar--82.2 +/- 2.3 years in the off-pump group vs 81.9 +/- 2.0 years in the on-pump group (p = 0.66). Preoperative risk was similar in both groups, but significantly more patients in the on-pump group had triple-vessel disease. Distal anastomoses were significantly fewer in the off-pump group than in the on-pump group at 2.0 +/- 1.0 vs 2.8 +/- 0.5 (p < 0.01). The off-pump group had a shorter postoperative ventilation--13.4 +/- 17.2 hours vs 45.2 +/- 52.8 hours (p < 0.05)--, and less blood transfused--16% vs 89% (p < 0.01)--than the on-pump group. Mean postoperative hospitalization and intensive care unit stay were 18.6 days and 3.2 days in the off-pump group, versus 37.1 days and 9.4 days in the on-pump group (p < 0.05). No difference was seen in the incidence of major postoperative complications between groups. No hospital deaths occurred in the off-pump group.


CONCLUSIONS
Off-pump CABG is thus a safe and effective for myocardial revascularization in the elderly.
Shimokawa
Tomoki
T
Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Kasuga, Fukuoka, Japan.
Minato
Naoki
N
Yamada
Noriko
N
Takeda
Yuji
Y
Hisamatsu
Yasushi
Y
Itoh
Manabu
M
D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome