Multivessel off-pump revascularization in octogenarians: early and midterm outcomes

Area of Science:

• Cardiovascular Surgery
• Geriatric Cardiology
• Minimally Invasive Cardiac Procedures

Background:

• Octogenarians undergoing coronary artery revascularization face elevated risks due to comorbidities and potential neurologic dysfunction.
• Cardiopulmonary bypass (CPB) increases morbidity and mortality in elderly patients.
• Off-pump coronary artery bypass grafting (OPCAB) offers a potentially safer alternative for this high-risk group.

Purpose of the Study:

• To evaluate the safety and efficacy of off-pump coronary artery bypass grafting (OPCAB) in octogenarian patients.
• To assess the early and intermediate clinical outcomes of OPCAB in this specific demographic.
• To determine the impact of OPCAB on the quality of life for octogenarians.

Main Methods:

• A retrospective analysis of prospectively collected data from 113 octogenarian patients who underwent OPCAB between January 1999 and August 2001.
• Data included patient demographics, surgical details, postoperative complications, and follow-up information obtained via telephone survey.
• Follow-up was completed for 90% of patients, with a mean duration of 13.2 months.

Main Results:

• The mean patient age was 83 years, with an average of 3.3 grafts per patient.
• The most common complication was atrial fibrillation (43%), and neurologic complications occurred in 4% of patients.
• One postoperative death (0.9% 30-day mortality) was recorded. At follow-up, 87% were angina-free, and 88% were free from cardiac readmission.

Conclusions:

• Off-pump multivessel revascularization in octogenarians is associated with excellent early and intermediate outcomes.
• OPCAB provides a satisfactory quality of life for elderly patients undergoing coronary artery bypass.
• This technique represents a viable and beneficial surgical option for octogenarians requiring coronary revascularization.