Coronary artery bypass grafting in octogenarians: long-term results.

Introduction: As surgical rovusoulariration is becoming more frequent in octogenarians, we reviewed our data to analyze the impact of coronary artery bypass grafting on short-and long-term morbidity and mortality. Methods: We performed a retrospective study of 101 consecutive patients aged 80 years or older, who underwent coronary artery bypass in a single cardiac center between January 2002 and December 2007. The patients were divided into two groups: off-pump (64.4%) and on-pump (35.6%), depending on whether the surgery was performed with cardiopulmonary bypass. Early results and those up to 6 years after surgery were assessed. Results: Baseline characteristics were similar between the groups and follow-up was 90% complete. There were no significant differences between groups in mean age (off-pump=82.7±18 years vs. on-pump=82.2±2.2 years; p=NS) or in logistic EuroSCORE (off-pump=11.2±12.3 vs. on-pump=8.5±5.1; p=NS). However, the off-pump group had less complete revascularization (off-pump=43.1% vs. on-pump=83.3%, p=0.0001) and shorter mean hospital stay (off-pump=9.3±5.4 days vs. on-pump=11.5±7.3 days; p=0.09). Both groups showed low hospital mortality (off-pump=1.5% vs. on-pump=2.8%, p=NS). At 6-year follow-up, off-pump surgery patients had the same late prognosis (total survival: off-pump=80% vs. on-pump=77.4%, p=NS; cardiovascular mortality: off-pump=15% vs. on-pump=16.1%, p=NS). Conclusion: In octogenarians coronary artery bypass grafting had excellent results. The off-pump technique, even though it can mean less complete revascularization, leads to shorter hospital stay and has the same 6-year results as in patients operated under cardiopulmonary bypass.