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Updated: Jun 10, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Isolated coronary artery bypass grafting in septuagenarians
Venkatesa Kumar Anakaputhur Rajan1, Chandrasekar Purushothaman2, Harikrishnan Subramanian2
1Department of Cardiothoracic Surgery, Kauvery Hospital, No. 199, Luz Church Road, Alwarpet, Chennai, 600004 India.
Insights
Coronary artery bypass grafting (CABG) is safe for septuagenarians (70-79 years) in India, showing low mortality and morbidity. This study confirms favorable outcomes for this elderly demographic undergoing cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Outcomes Research
Background:
- Increasing life expectancy leads to a growing number of elderly patients with coronary artery disease (CAD).
- Coronary artery bypass grafting (CABG) is a common treatment for severe CAD.
- Septuagenarians represent an expanding demographic undergoing major surgical procedures.
Purpose of the Study:
- To analyze the clinical outcomes of isolated coronary artery bypass grafting (CABG) in patients aged 70 to 79 years.
- To assess the safety and efficacy of CABG in the septuagenarian population.
- To identify factors associated with adverse events in this age group.
Main Methods:
- Retrospective analysis of 618 isolated CABG patients from January 2017 to December 2022.
- Inclusion criteria: patients aged 70-79 years.
- Data collection via medical records and phone calls, including EuroSCORE II for risk assessment.
Main Results:
- 132 (21.35%) patients were septuagenarians.
- Low in-hospital mortality (1.5%), stroke (0.85%), and atrial fibrillation (6.06%).
- High 1-year (98.1%), 5-year (85.5%), and 6-year (85.5%) actuarial survival rates.
Conclusions:
- Isolated CABG is a safe and effective procedure for septuagenarians in the Indian population.
- EuroSCORE II predicted major adverse cardiovascular events.
- Favorable short-term and long-term outcomes support CABG in this elderly cohort.
Abstract:
As life expectancy increases, the number of elderly patients with coronary artery disease requiring coronary artery bypass grafting (CABG) also increases. This study aims to analyse the outcomes of isolated CABG in septuagenarians. Isolated CABG patients between 70 and 79 years from January 1, 2017, to December 31, 2022, were included. Clinical data were obtained from medical records and through a phone call. Out of 618 isolated CABG patients, 132 (21.35%) were septuagenerians. Off-pump and on-pump beating heart CABG was performed in 123 (93.18%) and 9 (6.81%), respectively. Emergency CABG was performed in two patients (1.51%). The mean expected EuroSCORE II (European System for Cardiac Operative Risk evaluation) operative mortality was 2.51%. The incidence of in-hospital mortality, stroke and atrial fibrillation was 1.5%, 0.85% and 6.06%, respectively. An intra-aortic balloon pump was used in six patients (4.5%). The actuarial survival at 1 year, 5 years and 6 years were 98.1 ± 1.4%, 85.5 ± 4.7% and 85.5 ± 4.7%, respectively. The average duration of ventilation, intensive care unit (ICU) and hospital stay were 14.18 ± 10.37 h, 2.48 ± 0.89 days and 6.07 ± 1.8 days, respectively. EuroSCORE-II grading was associated with major adverse cardiovascular events. We conclude that performing CABG on septuagenarians in Indian population is safe.
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