[Off-pump versus conventional coronary artery bypass grafting in octogenarians].
Coronary artery bypass grafting (CABG) in elderly patients is becoming increasingly common. From January 1996 to February 2002, 836 patients underwent CABG in our hospital, of whom 33 patients (3.9%) were aged 80 years or older. We evaluated the clinical and short-term results of 7 cases of off-pump CABG (OPCAB) and 26 cases of conventional CABG (C-CABG). Mean patient age and preoperative risk factors were similar in both groups. The OPCAB group had significantly decreased operation time (218 versus 281 minutes, p<0.05), and the number of distal anastomoses was significantly fewer in the OPCAB group than in the C-CABG group (1.9 versus 3.8, p<0.05). The frequency of complete revascularization in C-CABG was significantly higher than that of the OPCAB group (84.6% versus 42.9%, p<0.05), and there were no differences in the incidence of major postoperative complications between the groups. There was no hospital death in either group. Cumulative cardiac event free rates were 75% at 1 year and 75% at 3 years in the OPCAB group and 100% at 1 year and 84.6% at 3 years in the C-CABG group (p<0.05). In conclusion, CABG is safe and effective for myocardial revascularization in octogenarians. Except for high-risk cases, complete revascularization with OPCAB or C-CABG should be performed, because favorable outcomes can be expected even in the elderly patients.
Sugimoto
Tsutomu
T
Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan.
Yamamoto
K
K
Tanaka
S
S
Saito
N
N
Kikuchi
C
C
Kasuya
S
S
Oguma
F
F
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D047549:Coronary Artery Bypass, Off-Pump / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome