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Published on: March 27, 2018
[Early and midterm outcomes of coronary artery bypass grafting in octogenarians]
Yang Wu1, Chang-qing Gao, Bo-jun Li
1People's Liberation Army Institute of Cardiac Surgery, Department of Cardiovascular Surgery, People's Liberation Army General Hospital, Beijing 100853, China.
Insights
Coronary artery bypass grafting (CABG) is safe for octogenarians, showing acceptable outcomes. Careful surgical planning and perioperative care are crucial for this elderly group.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Cardiac Surgery Outcomes
Context:
- Octogenarians represent a growing population undergoing cardiac procedures.
- Coronary artery bypass grafting (CABG) in this age group presents unique challenges.
- Limited data exists on the specific outcomes of isolated CABG in octogenarians.
Purpose:
- To evaluate early and midterm postoperative outcomes of isolated CABG in patients aged 80 years and older.
- To identify risk factors associated with CABG in the octogenarian population.
- To assess the safety and efficacy of both on-pump and off-pump CABG techniques in this demographic.
Summary:
- A review of 38 octogenarian patients (mean age 82.6 years) undergoing isolated CABG revealed a perioperative mortality of 2.6%.
- Common complications included stroke (4 cases) and atrial arrhythmias (25 cases).
- Midterm follow-up showed 92.6% of patients recovered without cardiac events, with a 6-month mortality of 15.8% (6/38).
Impact:
- Isolated CABG can be performed with acceptable morbidity and mortality in octogenarians.
- The findings underscore the importance of tailored surgical strategies and intensive perioperative management for elderly cardiac patients.
- This study provides valuable insights for optimizing care and improving outcomes for octogenarian CABG patients.
Objective:
To investigate the early and midterm postoperative outcomes and analyze risk factors of coronary artery bypass grafting (CABG) in octogenarians.
Methods:
Clinical data of 38 patients aged 80 years or greater receiving isolated coronary artery bypass grafting from September 2001 to November 2010 were reviewed. There were 33 male and 5 female patients, aging from 80 to 87 years with a mean of (82.6 ± 1.2) years. Twelve patients underwent conventional (on-pump) CABG and 26 patients underwent off-pump CABG. The number of bypass grafts was 1 to 5 (mean 2.5 ± 1.1). Left internal mammary artery was used in 37 (97.3%) patients.
Results:
The perioperative mortality was 2.6% (1/38). Postoperative complications included stroke (4 cases), respiratory infection (1 case). The atrial arrhythmias occurred in 25 patients. Intensive care unit and hospital length of stay lasted (3.8 ± 1.4) days and (15 ± 6) days, respectively. Totally 38 patients were followed up for 4 to 70 months. Six patients died during the follow-up period. The 92.6% patients recovered without any cardiac events.
Conclusions:
Isolated CABG can be performed safely with acceptable postoperative morbidity and mortality in octogenarians. Appropriate surgical strategy and intensive perioperative treatment must be enhanced in octogenarians who underwent CABG.
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