Off-pump coronary artery bypass grafting using only arterial grafts in elderly patients.
BACKGROUND
This study aimed to elucidate the safety and feasibility of off-pump coronary artery bypass grafting with only arterial grafts for elderly patients.


METHODS
Of 653 patients who underwent off-pump coronary artery bypass grafting from April 2000 to December 2003, 581 patients did so with only arterial grafts. The average age was 66.9 +/- 9.3 years. The patients were divided into the elder group E (75 years old or more: 111 cases) or the younger group Y (younger than 75 years old: 470 cases). The mean follow-up term was 21 +/- 12 months.


RESULTS
Additive and logistic EuroSCOREs of group E were significantly higher than those of group Y (p < 0.0001). The number of bypass grafts was 3.3 +/- 0.9 in group E and 3.3 +/- 1.1 in group Y (p = 0.43). The proportion of total revascularization was 74% (82 of 111) in group E and 80% (377 of 470) in group Y (p = 0.15). The number of bilateral implementations of internal thoracic artery was 10 (9.0%) in group E and 196 (42%) in group Y (p < 0.0001). The graft patency rate was 98.7% in group E and 97.8% in group Y (p = 0.96). Hospital mortality was 2.7% (3 of 111) in group E and 0.2% (1 of 470) in group Y (p = 0.095). The causes of death were unrelated to cardiac events. Major adverse cardiac events occurred in 5 patients (5.1%) in group E and in 24 patients (5.6%) in group Y (p > 0.99).


CONCLUSIONS
Off-pump coronary artery bypass grafting using only arterial grafts in elderly patients is as safe and feasible as in young patients.
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Kaoru
K
Matsuura
Junjiro
J
Kobayashi
Osamu
O
Tagusari
Ko
K
Bando
Kazuo
K
Niwaya
Hiroyuki
H
Nakajima
Toshikatsu
T
Yagihara
Soichiro
S
Kitamura
D000367:Age Factors; D000368:Aged; D001158:Arteries / Q000637:transplantation*; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome