title: Coronary artery bypass grafting in the octogenarians: should we intervene, or leave them be?
abstract: OBJECTIVE
  Coronary artery bypass grafting (CABG) is gradually increasing in the elderly population. We aimed to investigate the risk factors and the results of CABG along with the long term survival in patients at an age of 80 and older.
  
  
  METHODS
  Between January 2002 and December 2011, a total of 101 consecutive patients at an age of 80 and older who underwent CABG in our hospital were included in the study. The patients were followed and the long-term survival was estimated.
  
  
  RESULTS
  The mean age of the patients was 82.98 ± 2.27 years. Sixty-four (63.4%) were males and 37 (36.6%) were females. Emergency surgery, duration of cardiopulmonary bypass, the intensive care unit (ICU) stay, inotropic support, intra aortic balloon pulsation application, amount of erythrocyte transfusion and fresh frozen plasma transfusion and ventilation period were significantly higher in the patients who died in the hospital. The duration of cardiopulmonary bypass (CPB) was found to be an independent predictor of mortality (OR: 1.18, 95% CI 1.01-1.38, P = 0.034). The in-hospital mortality was 16.8%. Kaplan-Meier analyses revealed a survival ratio of 91.3% at one year, 82.9% at three years and 69.0% at five years.
  
  
  CONCLUSIONS
  Patients at the age of 80 and older can be candidates for the CABG procedure bearing in mind that they may have a longer ventilation period and intensive care unit stay. The morbidity and mortality of this age group is considered within an acceptable range. Approaches to minimize CPB, or the choice of off-pump surgery, may be a preventive method to lower the incidence of mortality. Hence, CABG may be performed in this age group with a satisfactory survival ratio.
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Anil
authors: A
authors: Ozen
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Ertekin Utku
authors: EU
authors: Unal
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Murat
authors: M
authors: Songur
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Sinan Sabit
authors: SS
authors: Kocabeyoglu
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Onur
authors: O
authors: Hanedan
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Metin
authors: M
authors: Yilmaz
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Basak Soran
authors: BS
authors: Turkcan
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Ferit
authors: F
authors: Cicekcioglu
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Sadi
authors: S
authors: Kaplan
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Kizilay Sok, No.4 06100 Sihhiye Ankara, Turkey.
authors: Cemal Levent
authors: CL
authors: Birincioglu
keywords: Cardiopulmonary bypass; Complications; Coronary artery bypass; Mortality; Octogenarians