ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Steven J. Hoff
Stephen K. Ball
William H. Coltharp
David M. Glassford, Jr
John W. Lea, IV
Michael R. Petracek
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hoff, S. J.
Right arrow Articles by Petracek, M. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hoff, S. J.
Right arrow Articles by Petracek, M. R.
Related Collections
Right arrow Coronary disease

Ann Thorac Surg 2002;74:S1340-S1343
© 2002 The Society of Thoracic Surgeons

Supplement: Cardiothoracic Techniques and Technologies

Coronary artery bypass in patients 80 years and over: is off-pump the operation of choice?

Steven J. Hoff, MDa*, Stephen K. Ball, MDa, William H. Coltharp, MDa, David M. Glassford, Jr, MDa, John W. Lea, IV, MDa, Michael R. Petracek, MDa

a St. Thomas Heart Institute, St. Thomas Hospital, Nashville, Tennessee, USA

* Address reprint requests to Dr Hoff, 4230 Harding Road, Suite 501, Nashville, TN 37205 USA
e-mail: shoff{at}csapc.net

Presented at the Eighth Annual Cardiothoracic Techniques and Technologies Meeting 2002, Miami Beach, FL, Jan 23–26, 2002.

BACKGROUND: Octogenarians are at increased risk for perioperative morbidity and mortality after coronary artery bypass. In this study we compared our experience with patients undergoing on-pump coronary artery bypass (CAB) and those undergoing off-pump coronary artery bypass (OPCAB) to assess outcomes.

METHODS: We used hospital database analysis in patients 80 years and older who underwent nonemergent coronary artery bypass with (N = 169) and without (N = 60) cardiopulmonary bypass from January 1999 through June 2001.

RESULTS: Both groups were at increased perioperative risk based on the Society of Thoracic Surgeons risk model (7.7% OPCAB vs 5.8% CAB, p = 0.03). There were no operative deaths in the OPCAB group but there were eight (4.7%) in the CAB group (p = NS). Perioperative stroke (0% OPCAB vs 7.1% CAB, p = 0.04), prolonged ventilation (1.7% OPCAB vs 11.8% CAB, p = 0.02), and transfusion rate (33% OPCAB vs 70.4% CAB, p < 0.001) were all lower in the OPCAB group. A shorter hospital stay (6.3 days OPCAB vs 11.5 days CAB, p < 0.001) resulted in lower hospital cost in the OPCAB group ($9,363 OPCAB vs $12,312 CAB, p < 0.001).

CONCLUSIONS: In this study, off-pump coronary artery bypass grafting in elderly patients was associated with fewer complications, a shorter hospital stay, and lower hospital cost. Off-pump coronary artery bypass grafting may be the operation of choice for octogenarians requiring surgical myocardial revascularization.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
J. Kempfert, U. T. Opfermann, M. Richter, T. Bossert, F. W. Mohr, and J. F. Gummert
Twelve-month patency with the PAS-port proximal connector device: a single center prospective randomized trial.
Ann. Thorac. Surg., May 1, 2008; 85(5): 1579 - 1584.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
M. L. Brown, T. M. Sundt III, and B. J. Gersh
Indications for Revascularization
Card. Surg. Adult, January 1, 2008; 3(2008): 551 - 572.
[Full Text]

Home page
 HeartHome page
S S Panesar, T Athanasiou, S Nair, C Rao, C Jones, M Nicolaou, and A Darzi
Early outcomes in the elderly: a meta-analysis of 4921 patients undergoing coronary artery bypass grafting--comparison between off-pump and on-pump techniques
Heart, December 1, 2006; 92(12): 1808 - 1816.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
I. J. Ferreira-Gonzalez, A. Ribera, P. Cascant, G. Permanyer-Miralda, and for the ARCA study group
Outcomes in off-pump vs. on-pump coronary artery bypass grafting stratified by pre-operative risk profile: an assessment using propensity score
Eur. Heart J., October 2, 2006; 27(20): 2473 - 2480.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
F. W. Sellke, J. M. DiMaio, L. R. Caplan, T. B. Ferguson, T. J. Gardner, L. F. Hiratzka, E. M. Isselbacher, B. W. Lytle, M. J. Mack, J. M. Murkin, et al.
Comparing On-Pump and Off-Pump Coronary Artery Bypass Grafting: Numerous Studies but Few Conclusions: A Scientific Statement From the American Heart Association Council on Cardiovascular Surgery and Anesthesia in Collaboration With the Interdisciplinary Working Group on Quality of Care and Outcomes Research
Circulation, May 31, 2005; 111(21): 2858 - 2864.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
D. Bainbridge, J. Martin, and D. Cheng
Off Pump Coronary Artery Bypass Graft Surgery Versus Conventional Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature
Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2005; 9(1): 105 - 111.
[Abstract] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J.-F. Legare, K. J. Buth, and G. M. Hirsch
Conversion to on pump from OPCAB is associated with increased mortality: results from a randomized controlled trial
Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 296 - 301.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Athanasiou, O. Aziz, O. Mangoush, S. Al-Ruzzeh, S. Nair, V. Malinovski, R. Casula, and B. Glenville
Does off-pump coronary artery bypass reduce the incidence of post-operative atrial fibrillation? A question revisited
Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 701 - 710.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
C. Weissman
Pulmonary Complications After Cardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 185 - 211.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Athanasiou, O. Aziz, O. Mangoush, A. Weerasinghe, S. Al-Ruzzeh, S. Purkayastha, J. Pepper, M. Amrani, B. Glenville, and R. Casula
Do off-pump techniques reduce the incidence of postoperative atrial fibrillation in elderly patients undergoing coronary artery bypass grafting?
Ann. Thorac. Surg., May 1, 2004; 77(5): 1567 - 1574.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
H. B. Ward and R. F. Kelly
OPCAB vs CABG: Who, What, When, Where?
Chest, March 1, 2004; 125(3): 815 - 816.
[Full Text] [PDF]

Home page
 CirculationHome page
J.-F. Legare, K. J. Buth, S. King, J. Wood, J. A. Sullivan, C. H. Friesen, J. Lee, K. Stewart, and G. M. Hirsch
Coronary Bypass Surgery Performed off Pump Does Not Result in Lower In-Hospital Morbidity Than Coronary Artery Bypass Grafting Performed on Pump
Circulation, February 24, 2004; 109(7): 887 - 892.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. T. Reston, S. J. Tregear, and C. M. Turkelson
Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting
Ann. Thorac. Surg., November 1, 2003; 76(5): 1510 - 1515.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. L. Ngaage
Off-pump coronary artery bypass grafting: the myth, the logic and the science
Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Muneretto, G. Bisleri, A. Negri, J. Manfredi, M. Metra, S. Nodari, and L. Dei Cas
Off-pump coronary artery bypass surgery technique for total arterial myocardial revascularization: a prospective randomized study
Ann. Thorac. Surg., September 1, 2003; 76(3): 778 - 783.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.