Surgical revascularization in elderly patients with and without cardiopulmonary bypass

The number of patients undergoing coronary artery bypass grafting (coronary artery bypass grafting-CABG) older than 70 years is increasing. Cardiac surgeons are investigate applicability of alternative and less invasive methods such as surgery without the use of cardiopulmonary bypass (CPB). The aim of this study was to compare the peri- and postoperative results of CABG in elderly patients operated with and without CPB.

The study included subjects older than 70 years, who underwent coronary bypass surgery at the BH Heart Center Tuzla in the period from August 2008 to August 2010, divided into two groups. Group A consisted of 50 patients operated without CPB, group B 50 patients operated with CPB, adjusted by sex, left ventricular ejection fraction values, EuroSCORE, and the number of bypass grafts was made.

In the group treated without the use CPB there were significantly lower values of the time-duration of mechanical ventilation, length of stay in the Intensive Care Unit (ICU), the amount of postoperative bleeding and blood recovered, the length of hospital stay, levels of serum creatinine, C-reactive protein and creatine kinase MB fraction.

CABG without the use of CPB has a number of advantages over the method with CPB in elderly patients, which is evident from the lower values of renal and inflammatory parameters and markers of myocardial lesion, less time spent on a ventilator, shorter length of stay in the ICU and total hospitalization time, less postoperative bleeding and blood transfusion.