Early results of off-pump coronary artery bypass graft surgery using bilateral internal thoracic artery grafts in octogenarian patients during ten years

Abstract

Realizing OP-CABG using BITA grafts had a high rate of postoperative morbidity, however, the mortality rate was low.

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

“…The main reason why underlying AF could aggravate the respiratory outcome relies on a number of factors, including; increased pulmonary arterial pressure due to impaired contraction of the left atrium, increased risk for production of atrial clots, especially in the left atrial appendage (LAA), lack of effective contractile force of the LAA and a multitude of other proposed mechanisms (31-33, 35). …”

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

“…It has been shown that patients with preexisting low ejection fraction (EF) are at a higher risk of developing respiratory problems than patients with normal EF (11,12,(32)(33)(34)(35)(36). Impaired left ventricular ejection fraction (LVEF) of less than 30%, history of previous myocardial infarction (36,37), and preexisting congestive heart failure, age, diabetes mellitus and arterial hypertension, have all been shown to be independent, significant predictors for developing these respiratory problems (30,31,35).…”

“…It has also been demonstrated that in patients undergoing CABG combined with valve disease, there is an increased possibility that the patients would require readmission to the ICU. In such patients, post-operative respiratory complications are the most common reasons for readmission (32)(33)(34)(36)(37)(38). In addition, a history of myocardial infarction during the last 90 days and a previous history of cardiac surgery, are both considered to be important predictors of postoperative respiratory problems (36-40).…”

“…It is also, considered to be a major risk factor for patients undergoing CABG, which could predict the possibility of postoperative mortality and morbidity in these patients, especially for diabetic patients with respiratory problems (30)(31)(32)(33)(34)(35)(36)(37)(38). On the other hand, there is a great amount of current evidence that demonstrates a very clear difference between, well controlled and poorly controlled diabetes mellitus, in predicting respiratory problems, hence, controlling the level of blood glucose in diabetics (at least below 200 mg/dL blood levels) would greatly affect the overall clinical outcome, including respiratory outcomes, in patients undergoing cardiac surgery, especially CABG, compared with poorly controlled diabetics (35)(36)(37).…”

Graft selection in elderly patients undergoing coronary artery bypass grafting

“…2 In contrast, recent reports have demonstrated that early postoperative outcomes in elderly patients are improving with the development of devices, surgical techniques, and postoperative management. 1,[3][4][5] The use of arterial grafts is considered to be one of the contributing factors of these improvements. 6,7 However, the selection of grafts for CABG tends to be decided according to the patient's general condition and life expectancy, especially in elderly patients.…”