title: Multivessel off-pump revascularization in octogenarians: early and midterm outcomes.
abstract: BACKGROUND
  Octogenarians are increasingly being referred for coronary artery revascularization. However, the prevalence of comorbid events and the propensity for neurologic dysfunction place octogenarians at higher risk for cardiopulmonary bypass-induced morbidity and mortality. Therefore, octogenarian patients represent a particularly attractive target for application of off-pump coronary artery bypass grafting.
  
  
  METHODS
  From January 1999 to August 2001, 113 octogenarians had off-pump coronary artery bypass grafting. Their data were prospectively entered into the cardiac surgery database and analyzed retrospectively. Follow-up information was obtained through telephone survey.
  
  
  RESULTS
  The mean age of the patients was 83 +/- 2.5 years, and the mean number of grafts per patient was 3.3 +/- 1. The most prevalent postoperative complication was atrial fibrillation (43%). Postoperative neurologic complications were seen in 5 patients (4%). There was one postoperative death (30-day mortality rate, 0.9%). The mean follow-up was 13.2 +/- 7 months and was complete for 90% of the patients. At the time of telephone survey, 85 (87%) of 98 patients were free from angina, and 91 (88%) were free from cardiac-related readmission. There were three late deaths. The majority of octogenarians (66%) reported that in retrospect, they would have the operation again.
  
  
  CONCLUSIONS
  Off-pump multivessel revascularization in octogenarians is associated with excellent early and intermediate outcomes and provides a satisfactory quality of life.
authors.affiliation: Department of Cardiothoracic Surgery, Newark Beth Israel Medical Center and Saint Barnabas Hospital, Newark, New Jersey, USA
authors.forename: Robert B
authors.initials: RB
authors.lastname: Beauford
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Goldstein
authors.forename: Frederic F
authors.initials: FF
authors.lastname: Sardari
authors.forename: Ravindra
authors.initials: R
authors.lastname: Karanam
authors.forename: Brandon
authors.initials: B
authors.lastname: Luk
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Prendergast
authors.forename: Paul G
authors.initials: PG
authors.lastname: Burns
authors.forename: Patricia
authors.initials: P
authors.lastname: Garland
authors.forename: Chunguang
authors.initials: C
authors.lastname: Chen
authors.forename: Onofrio
authors.initials: O
authors.lastname: Patafio
authors.forename: Craig R
authors.initials: CR
authors.lastname: Saunders
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000473:pathology* / Q000601:surgery*; D005260:Female; D015577:Geriatric Assessment; D006084:Graft Rejection; D006085:Graft Survival; D006355:Heart-Lung Machine; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis