Coronary Artery Bypass Grafting for Octogenarians: Experience in a Private Hospital and Review of the Literature
Hitoshi Hirose, MD, FICS,1 Atsushi Amano, MD,2 and Akihito Takahashi, MD1
Background and Methods: Indications for coronary artery bypass grafting (CABG) are expanding. We retrospectively analyzed the results of isolated CABG performed at Shin-Tokyo Hospital between January 1, 1992, and August 31, 2000. Preoperative, perioperative, and follow-up data of patients 80 years of age or older (group E, n=55) were collected and compared with those of patients between 75 and 79 years of age (group Y, n=197).
Results: Patient demographics were not significantly different except there was a greater incidence of co-existing valvular disease in group E. CABG was completed without any significant differences, except fewer distal anastomoses and more frequent off-pump CABG were performed in group E than in group Y. The in-hospital mortality rates of group E and Y were 1.8% and 2.5% (p=NS), respectively. The postoperative recovery (intubation time, ICU stay, and postoperative hospital stay) of group E was similar to group Y. During the mean follow-up of 2.6 years (maximum 8.4 years), the actuarial 3-year survival of groups E and Y was 84.5% and 94.9% (p=NS), respectively, excluding in-hospital mortality. The actuarial 3-year cardiac event-free rates were 100% in group E and 88.4% in group Y (p=NS).
Conclusion: CABG for octogenarians can be performed safely. Once adequate revascularization was established, the long-term cardiac events were similar to those of the younger patients. (Ann Thorac Cardiovasc Surg 2001; 7: 282-291)
Key words: coronary artery disease, aging, distant results, octogenarian
From the 1Department of Cardiovascular Surgery, Kobari General Hospital, and 2Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan
Received January 17, 2001; accepted for publication April 6, 2001
Address reprint requests to Hitoshi Hirose, MD: Kobari General Hospital, 29-1 Yokouchi, Noda City, Chiba 278-8501, Japan.
Presented at the 8th Annual Meeting of the Asian Society for Cardiovascular Surgery, Fukuoka, Japan, September 6-8, 2000.