[Graft selection in elderly patients undergoing isolated coronary artery revascularization]

Several studies have shown that off-pump coronary artery bypass (OPCAB) in elderly patients is better in terms of postoperative complications and length of hospital stay. We evaluated the outcomes of isolated OPCAB in octogenarians. From June 2002 to December 2004, 26 patients underwent isolated coronary artery bypass grafting (CABG). All patients underwent OPCAB. These included 4 emergency cases and 12 in an urgent situation, so the overall non-elective rate was 61.5%. There was no hospital death or serious complication. The mean number of grafts per patient was 3.2 +/- 1.6, and the complete revascularization rate was 90.4%. All patients received at least 1 arterial conduit, and 16 patients (61.5%) received all arterial grafts. Saphenous vein grafts were used in 10 patients. These values were not significantly different from those in patients in their 70s who underwent CABG during the same period. We conclude that even in high-risk octogenarian patients, with the aid of the off-pump technique, we can safely perform complete revascularization using more arterial conduits with minimal risk.