Arterial coronary artery bypass grafting is safe and effective in elderly patients
Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: Bilateral internal thoracic artery grafting in elderly patients is controversial. We compared the outcome of bilateral internal thoracic artery grafting with that of single internal thoracic artery and saphenous vein and radial artery conduits in these patients.
METHODS: Patients aged 70 years or more who underwent bilateral internal thoracic artery grafting between 1996 and 2008 (n = 1045) were compared with patients who underwent coronary artery bypass grafting with a single internal thoracic artery + saphenous vein graft (n = 582) or a single internal thoracic artery + radial artery (n = 249).
RESULTS: Prevalence of female gender, diabetes, emergency operation, and chronic obstructive pulmonary disease was lower in the bilateral internal thoracic artery grafting group compared with the internal thoracic artery + radial artery and internal thoracic artery + saphenous vein graft groups, whereas congestive heart failure and recent myocardial infarction were more prevalent in the bilateral internal thoracic artery grafting group. Operative mortality and sternal wound infections were not significantly different between groups. The mean follow-up was 8.17 ± 4.45 years. Ten-year survival (Kaplan-Meier) in the internal thoracic artery + saphenous vein graft group was significantly lower than in the bilateral internal thoracic artery grafting and internal thoracic artery + radial artery groups (P < .001). Assignment to the saphenous vein graft group was also associated with decreased adjusted survival (P < .001) compared with the bilateral internal thoracic artery and internal thoracic artery + radial artery groups.
CONCLUSIONS: This study supports the use of arterial grafts in elderly patients undergoing coronary artery bypass grafting.
| Errataetall: |
CommentIn: J Thorac Cardiovasc Surg. 2015 Sep;150(3):454-5. - PMID 26071971 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:150 |
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| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 150(2015), 3 vom: 01. Sept., Seite 607-12 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Medalion, Benjamin [VerfasserIn] |
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| Links: |
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| Themen: |
BITA |
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| Anmerkungen: |
Date Completed 26.02.2016 Date Revised 31.08.2015 published: Print-Electronic CommentIn: J Thorac Cardiovasc Surg. 2015 Sep;150(3):454-5. - PMID 26071971 Citation Status MEDLINE |
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| doi: |
10.1016/j.jtcvs.2015.06.032 |
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NLM251036510 |
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| 500 | |a CommentIn: J Thorac Cardiovasc Surg. 2015 Sep;150(3):454-5. - PMID 26071971 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Bilateral internal thoracic artery grafting in elderly patients is controversial. We compared the outcome of bilateral internal thoracic artery grafting with that of single internal thoracic artery and saphenous vein and radial artery conduits in these patients | ||
| 520 | |a METHODS: Patients aged 70 years or more who underwent bilateral internal thoracic artery grafting between 1996 and 2008 (n = 1045) were compared with patients who underwent coronary artery bypass grafting with a single internal thoracic artery + saphenous vein graft (n = 582) or a single internal thoracic artery + radial artery (n = 249) | ||
| 520 | |a RESULTS: Prevalence of female gender, diabetes, emergency operation, and chronic obstructive pulmonary disease was lower in the bilateral internal thoracic artery grafting group compared with the internal thoracic artery + radial artery and internal thoracic artery + saphenous vein graft groups, whereas congestive heart failure and recent myocardial infarction were more prevalent in the bilateral internal thoracic artery grafting group. Operative mortality and sternal wound infections were not significantly different between groups. The mean follow-up was 8.17 ± 4.45 years. Ten-year survival (Kaplan-Meier) in the internal thoracic artery + saphenous vein graft group was significantly lower than in the bilateral internal thoracic artery grafting and internal thoracic artery + radial artery groups (P < .001). Assignment to the saphenous vein graft group was also associated with decreased adjusted survival (P < .001) compared with the bilateral internal thoracic artery and internal thoracic artery + radial artery groups | ||
| 520 | |a CONCLUSIONS: This study supports the use of arterial grafts in elderly patients undergoing coronary artery bypass grafting | ||
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