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Multivessel off-pump coronary artery bypass surgery in the elderly
1Department of Surgery, Montreal Heart Institute, Research Center, 5000 Bélanger Street East, Montreal, Quebec, H1T 1C8, Canada.
Summary
Off-pump coronary artery bypass grafting (CABG) in elderly patients reduces atrial fibrillation and blood transfusions. This off-pump multivessel CABG is a safe alternative to traditional bypass surgery for seniors.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) in elderly patients carries higher risks.
- Off-pump CABG (OPCAB) may mitigate these risks by avoiding cardiopulmonary bypass (CPB).
Purpose of the Study:
- To evaluate the initial experience with off-pump multivessel coronary artery revascularization in patients aged 70 years and older.
- To compare outcomes of OPCAB with conventional CABG using CPB in this demographic.
Main Methods:
- A consecutive series of 98 patients aged 70+ undergoing OPCAB was compared to 497 patients aged 70+ who underwent CABG with CPB.
- Data were collected from 1996-1999 for OPCAB and 1995-1996 for CPB.
Main Results:
- While patients in the OPCAB group were slightly older, preoperative risk factors were similar.
- Perioperative mortality, myocardial infarction, and neurologic events were comparable between OPCAB and CPB groups.
- OPCAB demonstrated significantly lower rates of postoperative atrial fibrillation and reduced need for blood transfusions.
Conclusions:
- Multivessel OPCAB is a viable alternative to CPB for elderly patients (70+).
- OPCAB surgery in this age group is associated with improved outcomes, including reduced atrial fibrillation and transfusion needs.