Impact of Graft Strategies on the Outcome of Octogenarians Undergoing Coronary Artery Bypass Grafting.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-10-20 Epub Date: 2023-03-29 DOI:10.5761/atcs.oa.22-00193
Nicolai Bayer, Michael Schmoeckel, Peter Wohlmuth, Stephan Geidel
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Abstract

Purpose: To analyse the outcome of coronary artery bypass grafting (CABG) in octogenarians with coronary multivessel disease and the impact of different graft strategies and other factors.

Methods: Out of 1654 patients with multivessel disease who underwent CABG at our institution between January 2014 and March 2020, we investigated 225 consecutive patients with a median age of 82.1 years for survival prediction and need for coronary reintervention; a detailed outcome analysis was performed.

Results: At mean follow-up of 3.3 years, the overall survival was 76.4%. An indication for emergency operation (p = 0.002), age (p <0.001), chronic pulmonary disease (p = 0.024), and reduced renal or ventricular function (p <0.001) had the highest impact on limited survival. The combination outcome of survival and coronary reintervention was 1.7-fold improved (p = 0.024) after use of the bilateral internal thoracic artery (BITA) (66.2%). Off-pump CABG (12%) revealed no impact on survival. Smokers showed a poorer outcome (p = 0.004). The logistic European System for Cardiac Operative Risk Evaluation was highly effective for evaluating long-term outcomes (p <0.001).

Conclusions: BITA grafting normalizes survival and reveals a better outcome in octogenarians with multivessel disease. However, patients at risk of poorer survival were operated under emergency conditions and those with pulmonary disease and reduced ventricular or renal function.

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移植物策略对八旬老人冠状动脉搭桥术后疗效的影响。
目的:分析冠状动脉旁路移植术(CABG)在八旬冠状动脉多支病变患者中的疗效,以及不同移植策略和其他因素的影响。方法:在2014年1月至2020年3月期间在我们机构接受冠状动脉搭桥术的1654名多血管疾病患者中,我们对225名中位年龄为82.1岁的连续患者进行了生存预测和冠状动脉再干预需求调查;进行了详细的结果分析。结果:平均随访3.3年总生存率为76.4%,年龄(p结论:BITA移植使患有多血管疾病的80多岁老人的存活率正常化,并显示出更好的结果。然而,存活率较低的患者在急诊条件下进行了手术,而那些患有肺部疾病且心室或肾功能下降的患者则进行了手术。
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来源期刊
Annals of Thoracic and Cardiovascular Surgery
Annals of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.80
自引率
0.00%
发文量
56
审稿时长
4-8 weeks
期刊介绍: Information not localized
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