Isolated coronary artery bypass grafting in one hundred consecutive octogenarian patients

A multivariate analysis

W. Ko, K. H. Krieger, W. D. Lazenby, Y. T. Shin, Michael Goldstein, R. Lazzaro, O. W. Isom

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

One hundred consecutive patients aged 80 or older underwent isolated coronary artery bypass grafting for New York Heart Association functional class III (24%) or IV (76%) disease in our institution from 1985 to 1989. The operations were elective in 36 patients, urgent in 52, and emergent in 12. Twenty-eight patients had significant disease of the left main coronary artery, with the remainder having an average of 2.8 diseased coronary vessels. Preoperative left ventricular ejection fraction was considered good (>50%) in 62 patients, fair (30% to 50%) in 24 patients, and poor (<30%) in 14 patients. An average of 2.8 grafts were performed per patient, and the internal mammary artery was used in 10 patients. Univariate analysis of 36 perioperative factors followed by multivariate logistic regression analysis of the significant variables (p < 0.05) revealed that the urgency of the operation and left ventricular ejection fraction were independent predictors of operative mortality. There were 12 in-hospital deaths, and the mortality was significantly lower in the elective cases (2.8%) than in the urgent (13.5%) and emergent cases (33.3%). Major complications occurred in 14% of the elective cases, in 21% of the urgent cases, and in 67% of the emergent cases. The operative mortality rates for good, fair, and poor left ventricular ejection fraction were 4.9%, 12.5%, and 42.9%, respectively. Long-term follow-up averaging 22 months revealed a 77% actuarial probability of survival at 24 months and 51% at 48 months, with only two cardiac-related deaths. We conclude that coronary artery bypass grafting can be performed in octogenarians with a favorable outcome when done electively in patients with normal to moderately depressed left ventricular function.

Original languageEnglish (US)
Pages (from-to)532-538
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume102
Issue number4
StatePublished - 1991
Externally publishedYes

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Coronary Artery Bypass
Multivariate Analysis
Stroke Volume
Coronary Vessels
Mammary Arteries
Mortality
Hospital Mortality
Left Ventricular Function
Logistic Models
Regression Analysis
Transplants
Survival

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ko, W., Krieger, K. H., Lazenby, W. D., Shin, Y. T., Goldstein, M., Lazzaro, R., & Isom, O. W. (1991). Isolated coronary artery bypass grafting in one hundred consecutive octogenarian patients: A multivariate analysis. Journal of Thoracic and Cardiovascular Surgery, 102(4), 532-538.

Isolated coronary artery bypass grafting in one hundred consecutive octogenarian patients : A multivariate analysis. / Ko, W.; Krieger, K. H.; Lazenby, W. D.; Shin, Y. T.; Goldstein, Michael; Lazzaro, R.; Isom, O. W.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 102, No. 4, 1991, p. 532-538.

Research output: Contribution to journalArticle

Ko, W, Krieger, KH, Lazenby, WD, Shin, YT, Goldstein, M, Lazzaro, R & Isom, OW 1991, 'Isolated coronary artery bypass grafting in one hundred consecutive octogenarian patients: A multivariate analysis', Journal of Thoracic and Cardiovascular Surgery, vol. 102, no. 4, pp. 532-538.
Ko, W. ; Krieger, K. H. ; Lazenby, W. D. ; Shin, Y. T. ; Goldstein, Michael ; Lazzaro, R. ; Isom, O. W. / Isolated coronary artery bypass grafting in one hundred consecutive octogenarian patients : A multivariate analysis. In: Journal of Thoracic and Cardiovascular Surgery. 1991 ; Vol. 102, No. 4. pp. 532-538.
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