[Off-pump myocardial revascularization in the elderly: analysis of morbidity and mortality].
OBJECTIVE
To analyze the in-hospital outcome of elderly patients aged 70 years and older who underwent off-pump coronary artery bypass graft surgery with an intraluminal shunt in urgent, emergent, and elective coronary revascularizations.


METHODS
From July 1989 to July 2005, we analyzed 87 patients ranging in age from 70 to 92 years. Of the 87 patients enrolled, 50 (57.5%) patients had unstable angina, with three (3.4%) acute myocardial infarction; thirty-one (35.6%) patients underwent urgent and emergent surgery; thirteen (14.9%) patients had myocardial infarction in less than 30 days, and 34 (39.1%) in more than 30 days.


RESULTS
The main postoperative complications were: atrial fibrillation (32.2%), heart failure (12.6%), pneumonia (10.3%), septicemia (3.4%), acute myocardial infarction (2.3%), mediastinitis (1.1%) transient ischemic attack (1.1%), and pneumothorax (1.1%). The mean extubation time was 18.50+/-19.09 hours, the length of stay in the intensive care unit was 2.92+/-2.03 days, and hospital length of stay was 10.55+/-7.16 days. Packed red cells were given to nine (10.34%) patients and none of them was operated due to bleeding. The in-hospital mortality was 4.6%.


CONCLUSIONS
In patients over 70 years-old, elective and non-elective off-pump coronary artery bypass grafting with intracoronary shunt showed to be safe and effective, associated with low rates of postoperative complications and mortality in relation to the studied population.
Pinto E Silva
Ana Maria Rocha
AM
Faculdade de Ciências Médicas da Santa Casa de São Paulo. ana.mrp@uol.com.br
Campagnucci
Valquiria Pelisser
VP
Pereira
Wilson Lopes
WL
Rosa
Ronaldo F
RF
Franken
Roberto A
RA
Gandra
Sylvio M A
SM
Rivetti
Luiz A
LA
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000789:Angina, Unstable / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D009017:Morbidity; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D011184:Postoperative Period; D011300:Preoperative Care; D012501:Saphenous Vein / Q000637:transplantation; D016896:Treatment Outcome