Mid- and Long-Term Outcomes of Total Arterial Myocardial Revascularization in Patients Aged 70 Years and Older: A Single-Center Experience

Thorac Cardiovasc Surg. 2019 Sep;67(6):444-449. doi: 10.1055/s-0038-1669928. Epub 2018 Sep 15.

Abstract

Background: Patients receiving arterial grafts have superior late survival after coronary artery bypass graft (CABG) surgery. The aim of our study was to evaluate the mid- and long-term results of total arterial (TA) revascularization in the elderly.

Methods: Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed. Altogether, 356 patients who received isolated CABG were assigned to either TA group or control (CON) group.

Results: No significant differences were noted in regard to preoperative risk factors. The number of distal anastomoses was significantly higher in the CON group (3.6 ± 0.6 vs. 2.9 ± 0.8; p < 0.001). Postoperatively, no significant differences were noted in regard to morbidity or mortality. There were no significant differences in mortality rate at 1 year (5.6 vs. 5.2%; p = 0.98), or 5 years (9.0 vs. 12.1%; p = 0.39) between both groups. However, the TA group was associated with significantly higher rate of event-free survival (p = 0.017).

Conclusion: This study suggests that TA revascularization is an effective procedure. Lower rates of late cardiac events encourage the use of this concept for the elderly.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass / mortality
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery*
  • Female
  • Germany
  • Humans
  • Male
  • Mammary Arteries / surgery*
  • Postoperative Complications / mortality
  • Progression-Free Survival
  • Radial Artery / transplantation*
  • Retrospective Studies
  • Risk Factors
  • Saphenous Vein / transplantation*
  • Time Factors