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[Coronary artery bypass grafting in patients over 70 years old]

Hong-yin Li1, Qing-yu Wu, Ming-kui Zhang

  • 1Department of Cardiac Surgery, First Hospital of Tsinghua University, Beijing 100016, China.

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|July 15, 2009
PubMed

Insights

Coronary artery bypass grafting (CABG) in patients over 70 years old shows similar efficacy to younger patients. Both conventional CABG and off-pump CABG are effective, with no significant differences in outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Cardiology
  • Thoracic Surgery

Context:

  • Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
  • Elderly patients (over 70 years) present unique challenges and considerations for cardiac surgery.
  • Evaluating the safety and efficacy of CABG in this specific demographic is crucial for optimizing patient care.

Purpose:

  • To retrospectively analyze the experiences, indications, technique, and results of coronary artery bypass grafting (CABG) in patients over 70 years old.
  • To compare outcomes between conventional CABG (CCABG) and off-pump CABG (OPCAB) in elderly patients.
  • To assess the feasibility and effectiveness of achieving full revascularization in this population.

Summary:

  • Ninety-one patients aged 70-83 underwent CABG (72 CCABG, 19 OPCAB).
  • High utilization of left internal mammary artery (96.7%).
  • No significant differences in in-hospital mortality, cerebral infarction, pulmonary infection, intubation time, ICU stay, respiratory, or renal failure between CCABG and OPCAB groups. CCABG involved more grafts (P < 0.01).
  • Postoperative follow-up (3-36 months) showed one case of recurrent angina in the OPCAB group.

Impact:

  • Coronary artery bypass grafting (CABG) in patients over 70 years old can achieve efficacy comparable to younger patients.
  • Both conventional and off-pump CABG demonstrate similar safety and effectiveness profiles in the elderly.
  • The findings support the strategy of full revascularization to improve myocardial blood supply in elderly patients with coronary artery disease.
Abstract

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