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[Coronary artery bypass grafting in octogenarian]
1Second Department of Surgery, Gunma University Faculty of Medicine, Maebashi, Japan.
Insights
Coronary artery bypass grafting (CABG) is a viable option for octogenarians. This study found similar postoperative complication rates between elderly patients over 80 and those aged 70-79, suggesting age alone shouldn't preclude CABG.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Coronary artery bypass grafting (CABG) procedures in elderly patients are rising.
- Elderly individuals undergoing CABG face higher complication and mortality rates compared to younger patients.
- Octogenarians represent a growing demographic undergoing cardiac surgery.
Purpose of the Study:
- To evaluate the outcomes of isolated coronary artery bypass grafting (CABG) in octogenarian patients.
- To compare the results of CABG in patients over 80 years old with those aged 70-79.
- To determine if chronological age alone should be a contraindication for CABG in the elderly.
Main Methods:
- Retrospective analysis of 362 isolated CABG patients from January 1996 to December 1999.
- Patients were divided into two groups: 15 patients over 80 years old (80-year group) and 122 patients aged 70-79 years old (70-year group).
- Preoperative cardiac function (Canadian Cardiovascular Society class III or IV) was assessed and compared between groups.
Main Results:
- Preoperative cardiac function was significantly worse in the 80-year group (60% CCS class III or IV) compared to the 70-year group (29% CCS class III or IV).
- No significant differences were observed between the two groups regarding extracorporeal circulation time, aortic clamp time, number of bypasses, or postoperative complications.
- This suggests comparable surgical safety and outcomes for octogenarians and younger elderly patients undergoing CABG.
Conclusions:
- Coronary artery bypass grafting (CABG) is a safe and effective procedure for octogenarians.
- Chronological age alone should not be a reason to exclude octogenarian patients from CABG.
- Further research may explore long-term outcomes and specific risk stratification for this patient population.
Abstract:
Coronary artery bypass graftings (CABG) in elderly patients are increasing in recent years. Several studies have shown that the rate of complications and mortality is higher in elderly patients than in younger ones. This report presents results of CABG in octogenarians. From January 1996 to December 1999, 362 patients underwent isolated CABG, of whom 15 were over 80 years old (80-year group) and 122 were 70-79 years old (70-year group). Preoperative cardiac function was worse in the 80-year group than in 70-year group [60% vs 29% in Canadian Cardiovascular Society (CCS) class III or IV]. No significant difference was found between two groups in extracorporeal circulation time, aortic clamp time, the number of bypasses and postoperative complications. We conclude that CABG should not be excluded in octogenarians because of their chronological age alone.