Short term outcomes of total arterial coronary revascularization in patients above 65 years: a propensity score analysis.
BACKGROUND
Despite the advantages of bilateral mammary coronary revascularization, many surgeons are still restricting this technique to the young patients. The objective of this study is to demonstrate the safety and potential advantages of bilateral mammary coronary revascularization in patients older than 65 years.


METHODS
Group I included 415 patients older than 65 years with exclusively bilateral mammary revascularization. Using a propensity score we selected 389 patients (group II) in whom coronary bypass operations were performed using the left internal mammary artery and the great saphenous vein.


RESULTS
The incidence of postoperative stroke was higher in group II (1.5% vs. 0%, P = 0.0111). The amount of postoperative blood loss was higher in group I (908 +/- 757 ml vs. 800 +/- 713 ml, P = 0.0405). There were no other postoperative differences between both groups.


CONCLUSIONS
Bilateral internal mammary artery revascularization can be safely performed in patients older than 65 years. T-graft configuration without aortic anastomosis is particularly beneficial in this age group since it avoids aortic manipulation, which is an important risk factor for postoperative stroke.
Hassanein
Wael
W
Cardiac Surgery Department, Heart Institute Lahr/Baden, Germany. waelhassanein@yahoo.com
Hegazy
Yasser Y
YY
Albert
Alexander
A
Ennker
Ina C
IC
Rosendahl
Ulrich
U
Bauer
Stefan
S
Ennker
Juergen
J
D000367:Age Factors; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications; D057216:Propensity Score; D012501:Saphenous Vein / Q000637:transplantation; D020521:Stroke / Q000209:etiology
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