Arterial coronary artery bypass grafting is safe and effective in elderly patients

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. 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). 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. This study supports the use of arterial grafts in elderly patients undergoing coronary artery bypass grafting..

Medienart:	Artikel

Erscheinungsjahr:	2015
Erschienen:	2015

Enthalten in:	Zur Gesamtaufnahme - volume:150
Enthalten in:	The journal of thoracic and cardiovascular surgery - 150(2015), 3, Seite 607-612

Sprache:	Englisch

Beteiligte Personen:	Kramer, Amir [VerfasserIn] Mohr, Rephael [Sonstige Person] Ben-Gal, Ynai [Sonstige Person] Nesher, Nachum [Sonstige Person] Medalion, Benjamin [Sonstige Person] Eliyahu, Shimrit [Sonstige Person] Pevni, Dmitry [Sonstige Person]

Links:	Volltext www.ncbi.nlm.nih.gov

Themen:	Aged patients Surgery

doi:	10.1016/j.jtcvs.2015.06.032

funding:
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PPN (Katalog-ID):	OLC1969375957