Abstract
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.