Original article: cardiovascularMultivessel off-pump revascularization in octogenarians: early and midterm outcomes
Section snippets
Patient group
Our prospectively (daily) updated database (CAOS; Intelligent Business Solutions, Clemmons, NC) was queried to identify all patients who underwent CABG at Newark Beth Israel Medical Center and Saint Barnabas Hospital between January 1, 1999, and July 31, 2001. A total of 1,624 were found. Of these, 911 (56%) had OPCAB procedures, and 113 of them were octogenarians. The latter represents our study group. Of note, during this period, 29 octogenarians underwent traditional CABG.
Demographics,
Results
One hundred thirteen consecutive octogenarians underwent OPCAB during the study period. The demographic profile and the clinical characteristics are shown in Table 1. Mean age was 83 ± 2.5 years. The majority (81%) of patients had a history of hypertension. Previous myocardial infarction, tobacco use, diabetes, and congestive heart failure were also prevalent comorbid conditions. The mean left ventricular ejection fraction was 0.51 ± 0.11, and 11% of patients had a history of a previous
Comment
The explosive growth of OPCAB parallels the growth of the referral of elderly patients for revascularization. Most of the literature, however, addresses the use of OPCAB in younger patients with lower risk profiles, thus highlighting the trend to exclude this older population of patients when considering newer technologies. As the learning curve with OPCAB has been overcome and technical skill with the procedure has been enhanced, many investigators, including our group, believe that the
Acknowledgements
We gratefully acknowledge Gladys Belarmino, RN, and Therese Evangelista, RN, for their indispensable assistance with maintenance of the CAOS database.
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