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Coronary artery bypass grafting combined with aortic valve replacement in healthy octogenarians does not increase

Harald Brunvand1, Jon Offstad, Sigurd Nitter-Hauge

  • 1Department of Cardiology, Rikshospitalet, University of Oslo, Norway. harald.brunvand@rikshospitalet.no

Scandinavian Cardiovascular Journal : SCJ
|December 10, 2002
PubMed

Insights

Aortic valve replacement (AVR) with coronary artery bypass grafting (CABG) in octogenarians is safe. Combined AVR and CABG in healthy octogenarians showed no increased postoperative risk compared to isolated AVR.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Cardiology
  • Thoracic Surgery

Background:

  • Aortic stenosis is prevalent in octogenarians, often necessitating surgical intervention.
  • The combined procedure of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) in this age group requires careful risk assessment.
  • Indications and outcomes for combined AVR and CABG versus isolated AVR in elderly patients remain debated.

Purpose of the Study:

  • To evaluate the postoperative risk of combined AVR and CABG compared to isolated AVR in otherwise healthy octogenarians.
  • To assess the safety and efficacy of combined cardiac surgeries in elderly patients with critical aortic stenosis.

Main Methods:

  • Retrospective analysis of 94 patients over 80 years old undergoing AVR between 1994-1998.
  • Comparison of outcomes between 52 patients who underwent combined AVR and CABG and 42 patients who underwent isolated AVR.
  • Data collection from hospital records with a follow-up period of 0-7 years.

Main Results:

  • No significant difference in early mortality (9.5% for AVR vs. 7.6% for AVR and CABG; p=NS).
  • Similar three-year survival rates between the groups (78.5% for AVR vs. 80.7% for AVR and CABG; p=NS).
  • Patients were predominantly in NYHA class III and IV, with preserved left ventricular ejection fraction.

Conclusions:

  • Combined AVR and CABG can be safely performed in healthy octogenarians with aortic stenosis.
  • Concomitant coronary artery bypass grafting does not appear to increase surgical risk in this specific patient population.
  • The findings support the consideration of combined AVR and CABG in select elderly patients.
Abstract

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