title: [Coronary artery bypass in octogenarians; how to reduce operative mortality and enhance long-term quality of life].
abstract: Octogenarians are at increased risk for perioperative morbidity and mortality after coronary artery bypass. This study is aimed to elucidate the suitable operative strategy and perioperative management. A retrospective analysis was conducted of 54 consecutive patients with 80-years of age or older, who underwent elective isolated coronary artery bypass between May 1999 and May 2008. Mean follow-up was 43.3 months and 96.3% complete. Operavive mortality was 3.7% and the incidence of stroke was 3.7%. The 7-year cardiac survival was 80.4% and the 7-year cardiac event free was 65.0%. The use of arterial graft to the right coronary artery was identified as independent predictor of late cardiac event. Neither total arterial revascularization nor bilateral internal thoracic artery grafting was a significant cardiac event factor. This retrospective study suggests a benefit of the less invasive strategy in terms of operative mortality and morbidity. Application of fast-track treatment in octogenarians appears to be an effective approach to reduce perioperative morbidity and enhance long-term quality of life.
authors.affiliation: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Baba
authors.forename: S
authors.initials: S
authors.lastname: Ogawa
authors.forename: S
authors.initials: S
authors.lastname: Fukaya
authors.forename: H
authors.initials: H
authors.lastname: Kitamura
authors.forename: M
authors.initials: M
authors.lastname: Aoki
authors.forename: M
authors.initials: M
authors.lastname: Komeda
authors.forename: Y
authors.initials: Y
authors.lastname: Okawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D009155:Mutism; D012189:Retrospective Studies