Related Experiment Video
Updated: Jul 13, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
What factors influence the results of coronary artery bypass grafting in aged patients?
S Ishikawa1, B F Buxton, N Manson
1Department of Cardiac Surgery, Austin Hospital University of Melbourne, Melbourne, Australia. ishikawa@med.teikyo-u.ac.jp
Insights
Coronary artery bypass grafting (CABG) in octogenarians has higher risks, especially for urgent procedures. Elective CABG is recommended for older patients when feasible, considering factors like left ventricular ejection fraction and comorbidities.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Outcomes Research
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
- Outcomes in elderly patients undergoing CABG require careful evaluation to optimize surgical indications.
- Limited data exist on the specific outcomes of octogenarians compared to septuagenarians undergoing CABG.
Purpose of the Study:
- To compare early and late results of isolated coronary artery bypass grafting (CABG) in patients aged 70 years and older.
- To identify factors influencing operative mortality and long-term survival in elderly CABG patients.
- To refine indications for CABG in octogenarians versus septuagenarians.
Main Methods:
- A retrospective study of 1,973 patients aged 70+ who underwent isolated CABG.
- Patients were divided into octogenarians (80+ years, n=104) and septuagenarians (70-79 years, n=1869).
- Analysis included elective (EL) versus urgent/emergency (UR/EM) operations, left ventricular ejection fraction (LVEF), and comorbidities.
Main Results:
- Total operative mortality was 7% in octogenarians vs. 4% in septuagenarians.
- Urgent/emergency CABG mortality was significantly higher in octogenarians (21% vs. 6%).
- Poor LVEF (<49%), diabetes mellitus, and peripheral vascular disease were significant risk factors for operative death.
Conclusions:
- Preoperative poor left ventricular ejection fraction, diabetes mellitus, and peripheral vascular disease significantly increase operative death risk in elderly CABG patients.
- Elective coronary artery bypass grafting is advisable for octogenarians whenever feasible.
- Optimizing patient selection and managing comorbidities are crucial for improving CABG outcomes in the elderly.
Aim:
Early and late results were studied in order to improve the indication for coronary artery bypass grafting (CABG) and to enhance
Methods:
A total of 1 973 patients aged 70 years and older who had undergone isolated CABG were studied. Elective operations (EL) were performed in 1 716 patients and 257 patients underwent urgent or emergency operations (UR/EM). Patients were divided into two groups; 104 patients aged 80 years and older (Oct. Group) and 1 869 patients of septuagenarians (Sept. Group). There were no differences between the groups in the number of diseased vessels.
Results:
Total operative mortality rates in the Oct. and the Sept. groups were 7% and 4%, respectively. The operative mortality of elective surgery was 4% in both groups. The operative mortality of UR/EM CABG was significantly higher in the Oct. group than in the Sept. group (21% vs 6%). Operative mortality was significantly higher in patients with preoperative poor (<49%) left ventricular ejection fraction (LVEF) than in patients with higher (>50%) LVEF (6% vs 3%). Among preoperative risk factors, diabetes mellitus and peripheral vascular disease were significant contributory factors to operative death. In the follow-up study, 70% patients of the Oct. group and 72% patients of the Sept. group survived. Preoperative number of diseased vessels and number of CABG grafts did not influence the early and late
Conclusion:
Preoperative poor LVEF, diabetes mellitus and peripheral vascular disease were significant contributory factors to operative death. When feasible, CABG in octogenarians should be performed electively.
More Related Videos
05:25Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
09:04Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:27Coronary Artery Disease V: Interprofessional Care
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption