Coronary Artery Bypass Grafting in the Elderly: Are We Doing the Right Thing? Should These Patients Be Left Alone?

Abstract

Coronary artery bypass grafting (CABG) in the ageing population is always a debatable topic in most heart centres. Are we doing the right thing by intervening and performing isolated CABG in patients aged ≥75 years? This study aimed to investigate the predictive ability of EUROSCORE II, the revascularisation success of CABG with the survival outcomes of these patients. A retrospective analysis was performed of all patients aged ≥75 years who underwent CABG plus concomitant procedures in this single large tertiary institution during the last 8 years from 2015 to present. Predictive risk ability using EuroSCORE II, revascularisation success, and survival outcomes were analysed. The mean age, gender predominance, nature of surgery, elective vs emergency, duration of cardiopulmonary bypass, length of intensive care unit (ICU) stay, inotropic support, use of intra-aortic balloon pump, ventilation period in ICU, blood products transfusion rate, in-patient mortality rate with survival ratio, and overall 30-day mortality were calculated. EuroSCORE II predictive ability risk was calculated. Patient selection is the key. It is reasonable and rational to perform CABG in the elderly population, bearing in mind that they will have longer ICU and hospital stays, with a longer postoperative recovery period. Frailty risk models may establish a prediction of true operative risk.