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Off-Pump Coronary Artery Surgery in the Elderly

Department of Cardiovascular Surgery Escorts Heart Institute and Research Centre New Delhi, India
For reprint information contact: Zile S Meharwal, MCh Tel: 91 11 682 5000 Fax: 91 11 682 5013 email: meharwal{at}hotmail.com Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi 110025, India.

We compared the results of off-pump (n = 186) and on-pump (n = 389) coronary artery bypass grafting in elderly patients over 70 years old. Patients undergoing single-vessel revascularization were excluded from the study. The 2 groups matched in preoperative risk factors. Operative mortality was comparable (off-pump 2.2% versus on-pump 4.6%). The off-pump group fared better in intubation time (16 ± 4 hours versus 25 ± 5 hours), blood loss (365 ± 58 mL versus 584 ± 72 mL), the need for blood transfusion (31.7% versus 44%), reoperation for bleeding (0.5% versus 3.6%), atrial fibrillation (10.2% versus 18.5%), intensive care unit stay (21 ± 8 hours versus 34 ± 10 hours), and total hospital stay (5 ± 2 days versus 8 ± 3 days). Off-pump bypass surgery is thus safe for elderly patients and is associated with reduced morbidity and shorter hospitalization than on-pump surgery.

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