Coronary artery bypass grafting with the internal thoracic artery in patients over age 70

Abstract

The objective of this study was to determine whether there was higher mortality and morbidity in patients older than 70 years of age compared to those younger than 70 years who had coronary artery bypass grafting (CABG). The second objective was to determine whether the internal thoracic artery (ITA) grafts in patients aged more than 70 years were safe and beneficial. Patients were divided into 2 groups: “elderly” (125 patients aged 70 years or more) or “younger” (765 patients younger than 70 years). Early and long-term results and the incidence of postoperative complications were compared. The elderly group was subdivided into 96 patients in whom ITA grafts were used for CABG (elderly ITA) and 29 patients in whom only saphenous vein grafts (SVG) were used (elderly SVG). Hospital mortality was higher in elderly patients than in younger patients. There was no significant difference in hospital mortality between elderly ITA and elderly SVG patients. The incidence of postoperative complications was higher in elderly patients than younger patients. When comparing postoperative surgical complications between elderly ITA and elderly SVG patients, no significant differences were noted. Although the mortality after CABG was slightly higher in elderly patients than in younger patients, most of the elderly long-term survivors were able to lead ordinary lives. These results suggest that the use of the ITA in elderly patients did not increase the operative risk and postoperative surgical complications, and may have reduced the incidence of late cardiac events.