Background and aim: Ischemic heart disease is the leading cause of death
around the world. Coronary artery bypass grafting offers efficient
surgical revascularization for ischemic disease. Both on- or off-pump
coronary artery bypass methods provide promising results to
octogenarians, once complete vascularization is achieved. However,
off-pump bypass requires a certain level of experience to achieve
sufficient results. We have applied an off-pump coronary artery
bypass-first strategy to all generations since 2008. This study
investigated early and long-term results of surgical revascularization
for octogenarians by a team with an off-pump-first strategy. Methods:
All cases of isolated coronary artery bypass grafting performed since
2008 were identified and divided into a young group (age <80
years) and an old group (age >=80 years). Peri-operative
results were investigated retrospectively in both groups and long-term
results for the old group were assessed. Results: Among the 707
patients, 97% underwent off-pump bypass, and 94 cases were classified
to the old group. Distal anastomoses and ventilator time were identical
between groups (young vs. old: 3.3 vs. 3.2; 3.7 h vs. 3.7 h).
In-hospital death rates were 0.5% and 0% in the young and old groups,
respectively. With a mean follow-up of 1318 days, actual 1-, 3-, and
5-year survival rates for octogenarians were 92.1%, 81.2% and 68.3%,
respectively. Nearly half of the patients reached their nineties, which
was close to the life expectancy of the national general octogenarian.
Conclusions: An experienced team with an off-pump-first strategy could
provide valid therapeutic options for octogenarians.
Long-Term Survival and Freedom From Reintervention After Off-Pump Coronary Artery Bypass Grafting
