title: Coronary Artery Bypass Grafting in Elderly Patients: Insights from a Comparative Analysis of Total Arterial and Conventional Revascularization.
abstract: The benefits of total arterial (TAR) versus conventional (CR) revascularization are controversial in the higher-risk cohort of elderly patients. Taking for granted its benefit on long-term survival, we evaluated the effect of TAR on safety (death, myocardial infarction, and stroke) of patients undergoing CABG. Between 2000 and 2009, 487 patients >75 years underwent isolated CABG at our institution (150 TAR and 337 CR). Patients with arterial free-grafts were excluded. After propensity matching, the outcomes of 131 TAR and 127 CR patients were compared. TAR patients had lower incidence of post-operative myocardial infarction (p = 0.025) and stroke (p = 0.005). They also experienced shorter intensive care unit (p = 0.046) and ward stay (p = 0.028), lower output of TnI (p = 0.035), and less wound complications (leg included) (p = 0.0001), while mortality was comparable (p = 0.57). In our cohort of elderly patients with multivessel disease, TAR was associated with lower rates of myocardial infarction, stroke, and shorter hospital stay.
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Giacomo
authors.identifier: http://orcid.org/0000-0003-3640-1597
authors.initials: G
authors.lastname: Bortolussi
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Jonida
authors.initials: J
authors.lastname: Bejko
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gallo
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Comisso
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Carrozzini
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Guglielmi
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Testolin
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Toscano
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rubino
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tarzia
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.affiliation: Cardiac Surgery Unit; Department of Cardiac, Thoracic and Vascular Surgery, University of Padova Medical School, Padova, Italy. tbottio@gmail.com.
authors.forename: Tomaso
authors.initials: T
authors.lastname: Bottio
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
keywords: CABG; Coronary artery bypass grafting; Elderly patients; Total arterial revascularization