Is urgent coronary artery bypass grafting a safe option in octogenarians? A developing country perspective

Area of Science:

• Cardiology
• Geriatric Medicine
• Cardiac Surgery

Background:

• Increasing life expectancy leads to a larger elderly population requiring advanced medical interventions.
• Coronary artery disease (CAD) management in octogenarians presents unique challenges due to age-related comorbidities.
• Evaluating the safety and efficacy of cardiac surgical procedures in the very elderly is crucial.

Purpose of the Study:

• To assess the outcomes of coronary artery bypass grafting (CABG) specifically in octogenarian patients (aged 80 and above).
• To compare the results of emergent CABG versus elective CABG in this patient cohort.
• To analyze mortality, postoperative complications, and functional status following CABG in octogenarians.

Main Methods:

• Prospective data collection from 31 consecutive octogenarian patients undergoing CABG between January 2006 and December 2008.
• Analysis of key outcomes including mortality, intensive care unit (ICU) and hospital length of stay, surgical priority, and postoperative complications.
• Assessment of functional status and quality of life using the Seattle Angina Questionnaire during follow-up.

Main Results:

• No significant differences were observed in operative and postoperative variables between urgent and elective CABG groups.
• Three in-hospital deaths occurred; 82% of patients were alive at follow-up, with 19 in functional class I or II.
• 90% of patients reported minimal or no disability in daily activities, and 95% expressed satisfaction with their quality of life.

Conclusions:

• Coronary artery bypass grafting can be performed in octogenarian patients with favorable outcomes.
• The procedure leads to significant improvements in patients' functional status and overall quality of life.
• Urgent CABG in octogenarians yields comparable results to elective surgery, suggesting its viability in appropriate cases.