[Off-pump versus on-pump coronary artery bypass surgery. Comparison of 270 case-matched elderly patients].
BACKGROUND
Off-pump versus on-pump coronary artery bypass surgery: it still remains a matter of debate which method results in a lower incidence of perioperative morbidity and mortality. This case-matched study evaluates the outcome of elderly patients in both groups.


METHODS
All patients aged 75 and older, who underwent CABG from 1998 to 2002, were examined retrospectively. They were matched according to Euroscore and the number of diseased vessels. The Student's t-test and chi-square test were used where appropriate.


RESULTS
270 CABG patients were considered: 135 off-pump and 135 on-pump patients. Mean age was 78.4 +/- 3.1 versus 77.5 +/- 2.9 years, respectively. EuroSCORE was 7.11 +/- 2.3 in both groups; number of distal anastomoses per patient 1.7 +/- 0.74 versus 2.6 +/- 0.63 (p < 0.001), operation time 138 versus 177 minutes (p < 0.001). There were no significant differences in postoperative complications including hospital mortality 3.0 versus 3.7%, renal failure 8.9 versus 12.1% (new onset), acute myocardial infarction 1.5 versus 4.4% and cerebral events 0 versus 1.5%, respectively. The number of transfused packed cells was 2.6 +/- 2.8 versus 4.6 +/- 5.3 (p < 0.001). Intubation time and ICU stay were similar in both groups.


CONCLUSIONS
OPCAB is not associated with a reduction of perioperative mortality and morbidity in patients aged 75 and older.
Fritz
Markus K H
MK
Cardiothoracic Surgery, Bergmannsheil Bochum Ruhr-University Hospital, Bürkle-de-la-Camp-Pl. 1, 44788 Bochum, Germany. markus.k.fritz@ruhr-uni-bochum.de
Wiebalck
Albrecht
A
Buchwald
Dirk
D
Reber
Delawer
D
Klak
Krzysztof
K
Laczkovics
Axel M
AM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003627:Data Interpretation, Statistical; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome