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Heart Lung Circ. 2013 Dec;22(12):989-95. doi: 10.1016/j.hlc.2013.05.650. Epub 2013 Jul 2.

Anaortic off-pump coronary artery bypass grafting in the elderly and very elderly.

Author information

1
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Faculty of Medicine, The University of Sydney, Sydney, Australia; The Baird Institute for Heart and Lung Surgical Research, Sydney, Australia.

Abstract

BACKGROUND:

Elderly patients undergoing surgical revascularisation may disproportionately benefit from avoiding manipulation of the ascending aorta and cardiopulmonary bypass. In this multi-centre observational study, we sought to determine the 30-day outcomes of anaortic off-pump coronary artery bypass (OPCAB) in an elderly and very-elderly population.

METHODS:

Data were prospectively collected for all patients aged >70 years old (y) undergoing anaortic OPCAB at three hospitals between January 2002 and October 2011. Analysis was carried out on two age sub-groups (70-79 y vs. ≥80 y). Multiple logistic regression was used to identify predictors of post-operative 30-day mortality.

RESULTS:

In total, 1135 patients >70 years underwent anaortic OPCAB - 817 (72%) patients were aged 70-79 y while 318 (28%) were aged ≥80 y. The rate of mortality and morbidity for both groups was low: 30-day mortality (70-79 y: 1.8%; ≥80 y: 2.8%) or permanent stroke (70-79 y: 0.2%; ≥80 y: 0.9%). Chronic lung disease, a history of previous myocardial infarction and left main disease were independent predictors of 30-day mortality.

CONCLUSIONS:

OPCAB is associated with low rates of 30-day mortality and peri-operative stroke in this elderly and very elderly patient cohort. Anaortic OPCAB can provide excellent short-term post-operative outcomes and may give the elderly and very elderly population the opportunity to benefit from surgical coronary revascularisation.

KEYWORDS:

Elderly; Mortality; Off-pump coronary artery bypass grafting; Stroke; Very elderly

PMID:
23827207
DOI:
10.1016/j.hlc.2013.05.650
[Indexed for MEDLINE]

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