Complete arterial revascularization in patients older than 60 years

Abstract

Objective: The aim of this study was to evaluate the early and mid-term results of total arterial myocardial revascularization in patients older than 60 years. Methods: Sixty-five patients aged 60 years and older (mean 64.8+5.4, range 60–78 years) who underwent total arterial myocardial revascularization between January 2002 and June 2004 were evaluated prospectively. Forty-one patients (63.1%) had three-vessel coronary artery disease, 18 (27.7%) had two-vessel disease and six (9.2%) with left main lesion. Twenty-two patients had an old myocardial infarction (MI) and 11 unstabile angina pectoris. Mean EF was 55%. All patients underwent TAMR. In total 167 distal anastomoses were constructed (2.6 per patient) Pedicled LITA and RITA, free RITA and Radial arter were used as single or composite T- or Y-graft. Results: Patinent were followed-up in a mean period of 17.6+7.3 months (range 1–28 month). One patient died in this period (1.5%) one underwent PTCA (1.5%) two suffered angina pectoris (3.1%), there was no reoperation in this period. There was no occluded grafts in the early postoperative period (<90 days) patency 100%. Late (mean 16+2 month) LITA patency was 98.1% (one graft occluded), RITA patency was 93.4% (one graft occluded) and RA patency was 93.2% (three grafts occluded). Conclusions: This study showed that using only arterial conduits in coronary bypass surgery in elderly (patient aged over 60 years) were clearly evident with respect to higher patency rate, surgical reintervention and freedom from cardiac events.