Is advanced age a barrier to coronary bypass surgery? Our results of coronary bypass surgery in octogenarian patients

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Aim: The population of octogenarians requiring coronary artery bypass grafting (CABG) procedures has been growing rapidly. We aimed to evaluate the outcomes of CABG in patients aged 80 and over. Material and Methods: Included in the study were all consecutive patients undergoing CABG between 2002 and 2022. A total of 4650 patients were present; 70 of them were octogenarians. From patient medical records age, gender, use of an intra-aortic balloon pump, left ventricular ejection fraction, left main disease, use of CPB, number of distal coronary grafts, and comorbid conditions like diabetes, hypertension, preoperative renal failure, chronic obstructive pulmonary disease (COPD), prior myocardial infarction (MI), and postoperative bleeding necessitating repeat, postoperative ICU length of stay, 30-day mortality and morbidity information were gathered. Results: Patients had an average age of 81.47 years, with 71.43% being male. Octogenarians commonly presented with unstable angina (35.71%) and previous myocardial infarction (61.43%), while 10 had left main coronary lesions. Cardiac pathologies included aortic, mitral, and tricuspid valve issues in 5 cases, post-MI VSD in 3, and left ventricular aneurysms in 4. Postoperatively, 21 patients needed inotropes, 4 required an intra-aortic balloon pump, and the average intensive care unit stay was 2.5 days. Mortality was 1.42% in elective CABG. Conclusion: Although the operative risk is relatively high in octogenarian patients, isolated CABG can be performed with acceptable mortality rates in selected elective patients who do not require concomitant cardiac surgery.