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Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality
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Research Article
VOLUME: 76 ISSUE: 3
P: 227-233
September 2023

Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality

J Ankara Univ Fac Med 2023;76(3):227-233
DOI: 10.4274/atfm.galenos.2023.82712
Mehmet Cahit Sarıcaoğlu
Mustafa Adnan Uysalel
1. Ankara Üniversitesi Tıp Fakültesi, Kalp Merkezi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 14.08.2023
Accepted Date: 14.09.2023
Publish Date: 24.10.2023
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ABSTRACT

Objectives:

The increase in the number of coronary artery bypass graft (CABG) surgery in the elderly patients necessitates clinicans to make a rational decision considering the balance of risk and benefit. The aim of this study was to evaluate the risk factors affecting morbidity and mortality of CABG surgery in patients aged 70 years and over.

Materials and Methods:

Patients aged 70 years and older who had isolated coronary artery disease (CAD) and underwent isolated CABG surgery between January 2006 and December 2015, were included in the study. Patients who need urgent surgery, had history of cardiovascular surgery and/or had intervention to cardiac valves or aorta and opening of heart chambers during surgery due to other that cannulation and under age of 70 were excluded from the study. The demographic characteristics, preoperative, intraoperative and postoperative variables of the patients were examined retrospectively. The statistical analyses were performed in SPSS 15.0 program and p<0.05 was considered as statistically significant.

Results:

Total 349 patients were included in study, survival analysis was conducted in 312 (89.4%) patients. In-hospital mortality was 8.9%. Chronic obstructive pulmonary disease, history of cerebrovascular disease, history of myocardial infarction, class III-IV functional capacity of New York Heart Association and older age were found to be related with increased ventilation time and re-entubation. Age, diabetes mellitus, chronic obstructive pulmonary disease, carotis artery stenosis, class III-IV functional capacity of New York Heart Association, high preoperative glomerular filtration rate and use of left internal mammarian artery graft were found to be statistically significant in terms of increased postoperative mortality.

Conclusion:

This study demonstrates that CABG surgery in 70 age and older patients for treatment of CAD have a reasonable morbidity and mortality.

Keywords: Coronary Artery Bypass Grafting, 70 Years And Over, Morbidity, Mortality

References

1
World Health Organization. Fact sheet N°317. 2015. https://www.who.int/news-room/fact-sheets
2
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436-1442.
3
Ölüm Nedeni İstatistikleri, Türkiye İstatistik Kurumu. 2014. https://data.tuik.gov.tr/Bulten/Index?p=Olum-Nedeni-Istatistikleri-2014-18855
4
Kinsella K, Wan H. International population reports. An Aging World: 2008. https://www.census.gov/library/publications/2009/demo/p95-09-1.html
5
Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg. 2002;21:232-244.
6
Hedeshian MH, Namour N, Dziadik E, et al. Does increasing age have a negative impact on six-month functional outcome after coronary artery bypass? Surgery. 2002;132:239-244.
7
Naylor CD, Ugnat AM, Weinkauf D, et al. Coronary artery bypass grafting in Canada: What is its rate of use? Which rate is right? CMAJ. 1992;146:851-859.
8
Yanagawa B, Puskas JD, Verma S, et al. Coronary Artery Bypass Graft Should Be Considered in Octogenarians With Multivessel Coronary Disease. Can J Cardiol. 2016;32:1045.e1-1045.e3.
9
Tsai TP, Nessim S, Kass RM, et al. Morbidity and mortality after coronary artery bypass in octogenarians. Ann Thorac Surg. 1991;51:983-986.
10
Merrill WH, Stewart JR, Frist WH, et al. Cardiac surgery in patients age 80 years or older. Ann Surg. 1990;211:772-775.
11
Pawlaczyk R, Swietlik D, Lango R, et al. Off-pump coronary surgery may reduce stroke, respiratory failure, and mortality in octogenarians. Ann Thorac Surg. 2012;94:29-37.
12
Sun L, Zhou M, Ji Y, et al. Off-pump versus on-pump coronary artery bypass grafting for octogenarians: A meta-analysis involving 146 372 patients. Clin Cardiol. 2022;45:331-341.
13
Ozen A, Unal EU, Songur M, et al. Coronary artery bypass grafting in the octogenarians: should we intervene, or leave them be? J Geriatr Cardiol. 2015;12:147-152.
14
Peterson ED, Cowper PA, Jollis JG, et al. Outcomes of coronary artery bypass graft surgery in 24,461 patients aged 80 years or older. Circulation. 1995;92(9 Suppl):II85-II91.
15
Alexander KP, Anstrom KJ, Muhlbaier LH, et al. Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network. J Am Coll Cardiol. 2000;35:731-738.
16
Ho CH, Chen YC, Chu CC, et al. Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease. Medicine (Baltimore). 2016;95:e2926.
17
Safaie N, Montazerghaem H, Jodati A, et al. In-Hospital Complications of Coronary Artery Bypass Graft Surgery in Patients Older Than 70 Years. J Cardiovasc Thorac Res. 2015;7:60-62.
18
Hirose H, Amano A, Takahashi A. Coronary artery bypass grafting for octogenarians: experience in a private hospital and review of the literature. Ann Thorac Cardiovasc Surg. 2001;7:282-291.
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