[Left internal mammary artery in octogenarians. Is its use in coronary revascularization justified?]

Area of Science:

• Cardiovascular Surgery
• Geriatric Medicine
• Thoracic Surgery

Background:

• Increasing life expectancy leads to more octogenarians requiring coronary artery bypass procedures.
• Arterial conduits were traditionally avoided in elderly patients due to perceived risks.
• Concerns existed regarding increased morbidity-mortality without survival benefits.

Purpose of the Study:

• To evaluate the safety and efficacy of left internal mammary artery (LIMA) implantation in patients over 70 undergoing coronary artery bypass grafting (CABG).
• To determine if LIMA use in octogenarians increases perioperative complications.
• To assess the short- and long-term benefits of arterial conduits in elderly CABG patients.

Main Methods:

• Retrospective analysis of 148 patients aged 70+ who underwent CABG with LIMA implantation.
• Data collected over a twelve-year period.
• Analysis focused on mortality and perioperative complications like bleeding and mediastinal infections.

Main Results:

• The overall mortality rate was 3.37%.
• No significant increase in perioperative complications, including bleeding or mediastinal infections, was observed.
• LIMA implantation was found to be safe in this elderly population.

Conclusions:

• Left internal mammary artery (LIMA) grafting is beneficial for elderly patients (over 70) undergoing coronary artery bypass grafting (CABG).
• Arterial conduit use in octogenarians does not elevate perioperative risks.
• LIMA offers both short- and long-term advantages for older patients needing CABG.