Efficacy and safety of off-pump coronary artery bypass graft in octogenarians

Abstract

Objective To investigate the efficacy and safety of beating heart or off-pump coronary artery bypass grafting(OP-CAB) operation in octogenarians with coronary heart disease. Methods Among the 143 cases of octogenarians with coronary heart disease receiving coronary artery bypass grafting(CABG) operation in Beijing Hospital from August 2009 to December 2014, 58 cases were in OP-CAB group, and 85 cases were in on-pump coronary artery bypsaa grafting(ON-CAB) group.Mean age of all 143 patients was 82.6±2.7 years.The clinic data were compared between the two groups. Results There were no differences in number of bypass vessels between ON-CAB and OP-CAB group.Compared with ON-CAB, OP-CAB group improved the parameters of the postoperative 24 hours drainage〔325.6±85.3 vs.(645.8±65.5)ml〕, myocardial infarction〔1.72%(1 case)vs.3.53%(3 case)〕, new onset of atrial fibrillation〔15.52%(9 cases)vs.29.41%(25 cases)〕, neurologic complications〔5.17%(3 cases)vs.8.24%(7 cases)〕, acute renal failure〔1.72%(1 cases)vs.3.53%(3 cases)〕, respiratory infection〔3.45%(2 cases)vs.7.05%(6 cases)〕, mortality rate in 30 days〔1.72%(1 cases)vs.4.71%(4 cases)〕and transfusion requirements〔(1.90±0.78)vs.(4.58±0.56)units〕. Meanwhile, the operative duration, ICU stay time and postoperative hospital time〔(184.5±45.4)minutes, (2.54±0.55)days, (8.45±0.56)days, respectively〕in OP-CAB group were significantly shorter than in ON-CAB group〔(315.2±68.3)minutes, (4.32±0.60)days, (13.29±0.64)days, respectively, P<0.05〕. Conclusions Compared with ON-CAB, OP-CAB could improve the efficacy and reduce the incidence of complication and mortality for octogenarians.It is a safe and efficacious method of myocardial revascularization in the elderly patients, and may actually be preferential in these patients. Key words: Coronary disease; Coronary artery bypass, off-pump