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Results of off-pump coronary artery bypass grafting with off-pump first strategy in octogenarian
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  • Hideki Kitamura,
  • Mototsugu Tamaki,
  • Yasuhiko Kawaguchi,
  • Yasuhide Okawa
Hideki Kitamura
Nagoya Heart Center

Corresponding Author:[email protected]

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Mototsugu Tamaki
Nagoya Heart Center
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Yasuhiko Kawaguchi
Nagoya Heart Center
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Yasuhide Okawa
Nagoya Heart Center
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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.
11 Sep 2021Submitted to Journal of Cardiac Surgery
11 Sep 2021Assigned to Editor
11 Sep 2021Submission Checks Completed
11 Sep 2021Reviewer(s) Assigned
13 Sep 2021Review(s) Completed, Editorial Evaluation Pending
13 Sep 2021Editorial Decision: Accept
Dec 2021Published in Journal of Cardiac Surgery volume 36 issue 12 on pages 4611-4616. 10.1111/jocs.16055