Off-pump coronary artery bypass in octogenarians: results of a statewide, matched comparison

Suarez‐Pierre, Alejandro; Crawford, Todd C.; Fraser, Charles D.; Zhou, Xun; Lui, Cecillia; Taylor, Bradley S.; Wehberg, Kurt E.; Conte, John V.; Whitman, Glenn J.R.; Salenger, Rawn

doi:10.1007/s11748-018-1025-8

Cited by 6 publications

(31 citation statements)

References 21 publications

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“…Off-pump CABG has been associated with better operative mortality and morbidity in octogenarians; however, results vary and there is no clear benefit for this patient population. 32,33 Moreover, off-pump CABG was not associated with improved outcomes in the present study. There are numerous factors that could be associated with mortality and readmission in elderly patients, including inherently subjective determinants such as measures of frailty, which have been associated with increased morbidity, mortality, and functional decline after cardiac surgery.…”

Section: Commentcontrasting

confidence: 51%

Midterm Outcomes for Isolated Coronary Artery Bypass Grafting in Octogenarians

Bianco

Kilic

Gleason

et al. 2020

The Annals of Thoracic Surgery

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Section: Commentcontrasting

confidence: 51%

Midterm Outcomes for Isolated Coronary Artery Bypass Grafting in Octogenarians

Bianco

Kilic

Gleason

et al. 2020

The Annals of Thoracic Surgery

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“…These findings are consistent with the trends reported in other countries. For example, octogenarians comprised 8.2% of a contemporary US population scheduled for isolated coronary surgery [7]. The recently observed plateau with further decline may be related to the rapid advances in non-surgical therapies, including implantation of drug-eluting stents and the implementation of newer anticoagulant and antiplatelet medications in combination with aggressive lipid-lowering therapy.…”

Section: Plos Onementioning

confidence: 99%

“…The debate concerning the superiority of OPCAB over CABG (and vice versa) has continued for many years [4,5]. Proponents of the OPCAB technique have advocated for its specific use in octogenarians since the beginning of this debate [6] and many studies continue to evaluate the potential benefit [7]. Evidence from meta-analyses indicates that utilizing the off-pump technique significantly reduces stroke, renal failure, ventilation time, atrial fibrillation, transfusion requirements, and postoperative length of stay when compared with conventional CABG using cardiopulmonary bypass [8,9].…”

Section: Introductionmentioning

confidence: 99%

Off-pump versus on-pump coronary artery surgery in octogenarians (from the KROK Registry)

et al. 2020

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Background According to the medical literature, both on-pump and off-pump coronary artery surgery is safe and effective in octogenarians. Objectives The aim of our study was to examine the epidemiology, in-hospital outcomes and long-term follow-up results in octogenarians undergoing off-pump and on-pump coronary artery surgery utilizing nationwide registry data. Methods All octogenarians (� 80 years) enrolled in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), who underwent isolated coronary surgery between January 2006 and September 2017 were identified. Preoperative data, perioperative complications, hospital mortality and long-term mortality were analyzed. Unadjusted and propensitymatched comparisons were performed between octogenarians undergoing off-pump and on-pump coronary artery bypass surgery.

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“…Off‐pump CABG (OPCAB) eliminates the use of cardiopulmonary bypass, and so might benefit high‐risk patients or complex cases with concomitant disease 7 . However, whether OPCAB is better for octogenarian than conventional CABG remains controversial 7–10 . Both methods provide promising early and midterm results to octogenarians, once complete vascularization is achieved 10 .…”

Section: Introductionmentioning

confidence: 99%

Results of off‐pump coronary artery bypass grafting with off‐pump first strategy in octogenarian

Kitamura

Tamaki

Kawaguchi

et al. 2021

Journal of Cardiac Surgery

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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.

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Off-pump coronary artery bypass in octogenarians: results of a statewide, matched comparison

Cited by 6 publications

References 21 publications

Midterm Outcomes for Isolated Coronary Artery Bypass Grafting in Octogenarians

Midterm Outcomes for Isolated Coronary Artery Bypass Grafting in Octogenarians

Off-pump versus on-pump coronary artery surgery in octogenarians (from the KROK Registry)

Results of off‐pump coronary artery bypass grafting with off‐pump first strategy in octogenarian

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