Off-pump coronary artery bypass grafting using only arterial grafts in elderly patients.

Abstract

This study aimed to elucidate the safety and feasibility of off-pump coronary artery bypass grafting with only arterial grafts for elderly patients. Of 653 patients who underwent off-pump coronary artery bypass grafting from April 2000 to December 2003, 581 patients did so with only arterial grafts. The average age was 66.9 +/- 9.3 years. The patients were divided into the elder group E (75 years old or more: 111 cases) or the younger group Y (younger than 75 years old: 470 cases). The mean follow-up term was 21 +/- 12 months. Additive and logistic EuroSCOREs of group E were significantly higher than those of group Y (p < 0.0001). The number of bypass grafts was 3.3 +/- 0.9 in group E and 3.3 +/- 1.1 in group Y (p = 0.43). The proportion of total revascularization was 74% (82 of 111) in group E and 80% (377 of 470) in group Y (p = 0.15). The number of bilateral implementations of internal thoracic artery was 10 (9.0%) in group E and 196 (42%) in group Y (p < 0.0001). The graft patency rate was 98.7% in group E and 97.8% in group Y (p = 0.96). Hospital mortality was 2.7% (3 of 111) in group E and 0.2% (1 of 470) in group Y (p = 0.095). The causes of death were unrelated to cardiac events. Major adverse cardiac events occurred in 5 patients (5.1%) in group E and in 24 patients (5.6%) in group Y (p > 0.99). Off-pump coronary artery bypass grafting using only arterial grafts in elderly patients is as safe and feasible as in young patients.