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DOI: 10.1055/s-2001-19016
© Georg Thieme Verlag Stuttgart · New York
Complete Arterial Revascularisation in Patients Older than 70 Years[1]
Publikationsverlauf
Publikationsdatum:
17. Dezember 2001 (online)
![](https://www.thieme-connect.de/media/thoracic/200106/lookinside/thumbnails/10.1055-s-2001-19016-1.jpg)
Background: Coronary artery bypass grafting (CABG) using left internal thoracic artery and vein grafts is standard in patients of advanced age. A number of these patients, however, present without suitable vein grafting material and thus require the use of arterial conduits. In order to investigate the safety and efficacy of complete arterial revascularisation, we have compared the perioperative results of patients older than 70 years with conventional CABG and complete arterial revascularisation. Patients and Methods: Group I (n = 172) with conventional CABG in 1999 was compared with 152 patients (group II) with complete arterial CABG between 1996 and July 2000. There were no significant differences regarding age, gender, left ventricular ejection fraction or incidence of three-vessel disease or left main stenosis. The proportion of reoperations was significantly higher in group II (16 %) vs. group I (4 %). Results: A mean of 3.7 ± 0.7 anastomoses (I) versus 4.0 ± 0.9 (II) were performed per patient (p = n. s.). Mean operating time (I: 210 ± 46 min; II: 194 ± 46 min) and bypass time (I: 87 ± 25 min; II: 78 ± 29 min) were significantly lower in group II. Ischemic time (I: 46 ± 22 min; II: 49 ± 21 min) was not significantly different. The incidence of sternal dehiscence was 2.9 % (I: n = 5) vs. 1.3 % (II: n = 2). Hospital mortality was 4.6 % in group I vs. 3.9 % (II). Conclusion: Complete arterial revascularisation is a safe option in patients aged over 70. It remains to be shown whether it may also have advantage in the long term.
Key words:
Coronary surgery - Elderly patient - Arterial grafts - T-grafts - Radial artery
1 Presented at the 30th Annual Meeting of the German Society of Thoracic and Cardiovascular Surgery, February 2001
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1 Presented at the 30th Annual Meeting of the German Society of Thoracic and Cardiovascular Surgery, February 2001
Dr. med. Nikolaos Nikoloudakis
Klinik für Thorax- und Herz-Gefäßchirurgie
Universitätskliniken des Saarlandes
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Germany
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