[Indication and strategy of on-pump coronary artery bypass grafting in elderly patients]

Area of Science:

• Cardiology
• Geriatric Medicine
• Cardiothoracic Surgery

Background:

• Increasing elderly population necessitates evaluation of surgical risks.
• Coronary artery bypass grafting (CABG) in older adults requires careful risk assessment.

Purpose of the Study:

• To assess the safety and outcomes of on-pump CABG in elderly patients (≥70 and ≥80 years).
• To compare the risks and complications of on-pump CABG between elderly and younger patient cohorts.

Main Methods:

• Retrospective analysis of 12 patients aged ≥80 undergoing on-pump CABG, compared to 1,988 younger patients.
• Comparison of 341 patients aged ≥70 with 1,659 younger patients undergoing on-pump CABG.
• Evaluation of pre- and postoperative factors, including mortality and complications.

Main Results:

• No in-hospital mortality or postoperative complications observed in the 12-patient group (≥80 years).
• Elderly patients (≥70 years) were more severely ill preoperatively but had similar postoperative complication rates compared to younger patients.
• Higher in-hospital mortality observed in the elderly group (≥70 years) despite similar complication rates.

Conclusions:

• On-pump CABG can be performed safely in elderly patients, including those ≥80 years, with meticulous pre-, intra-, and postoperative management.
• While risks are higher in older adults, careful surgical planning mitigates adverse outcomes.
• On-pump CABG remains a viable option for elderly patients with coronary artery disease.