Coronary artery bypass grafting in patients over 70 years old
Kawata, T.; Kitamura, S.; Taniguchi, S.; Kobayashi, S.; Mizuguchi, K.; Nishioka, H.; Kameda, Y.; Niwaya, K.; Tsuji, T.; Tabayashi, N.
Kyobu Geka. Japanese Journal of Thoracic Surgery 50(8 Suppl): 678-681
1997
ISSN/ISBN: 0021-5252 PMID: 9251493 Document Number: 471044
We examined the outcome of CABG in 157 patients aged over 70 years. The average age was 72.7 +/- 2.4 years: the number of the diseased vessels, 2.5 +/- 0.7/pt; the mean preoperative LVEF, 0.55 +/- 0.17 and the number of patients with left main trunk disease, 40 (26%). The mean number of bypass grafts was 2.8 +/- 0.8/pt. In 131 patients (83.4), left internal thoracic artery (LITA) was used to bypass the left anterior descending artery (LAD). The postoperative hospital mortality rate was 6.4%. After 10 years of follow-up, the actuarial survival rate and cardiac event-free rate were 73.6% and 88.9%, respectively calculated by the Kaplan-Meier method. A comparison of the long-term results of CABG with and without ITA grafting, showed no statistical difference with respect to actuarial survival rate. However, the cardiac event-free rate was improved by using an ITA graft (92.4% with an ITA vs 77.3% without an ITA, p = 0.047). This result suggested that the use of ITA in patients over 70 years old reduced the incidence of postoperative cardiac events without increasing the operative risk.