Services on Demand
Revista Brasileira de Cirurgia Cardiovascular
On-line version ISSN 1678-9741
PINTO E SILVA, Ana Maria Rocha et al. Off-pump myocardial revascularization in the elderly: analysis of morbidity and mortality. Rev Bras Cir Cardiovasc [online]. 2008, vol.23, n.1, pp. 40-45. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76382008000100008.
OBJECTIVE: To analyze the in-hospital outcome of elderly patients aged 70 years and older who underwent off-pump coronary artery bypass graft surgery with an intraluminal shunt in urgent, emergent, and elective coronary revascularizations. METHODS: From July 1989 to July 2005, we analyzed 87 patients ranging in age from 70 to 92 years. Of the 87 patients enrolled, 50 (57.5%) patients had unstable angina, with three (3.4%) acute myocardial infarction; thirty-one (35.6%) patients underwent urgent and emergent surgery; thirteen (14.9%) patients had myocardial infarction in less than 30 days, and 34 (39.1%) in more than 30 days. RESULTS: The main postoperative complications were: atrial fibrillation (32.2%), heart failure (12.6%), pneumonia (10.3%), septicemia (3.4%), acute myocardial infarction (2.3%), mediastinitis (1.1%) transient ischemic attack (1.1%), and pneumothorax (1.1%). The mean extubation time was 18.50±19.09 hours, the length of stay in the intensive care unit was 2.92±2.03 days, and hospital length of stay was 10.55±7.16 days. Packed red cells were given to nine (10.34%) patients and none of them was operated due to bleeding. The in-hospital mortality was 4,6%. CONCLUSIONS: In patients over 70 years-old, elective and non-elective off-pump coronary artery bypass grafting with intracoronary shunt showed to be safe and effective, associated with low rates of postoperative complications and mortality in relation to the studied population.
Keywords : Myocardial revascularization; Aged; Coronary disease [surgery]; Hospital mortality; Postoperative complications.