Clinical effect of off-pump coronary artery bypass grafting for the patients over 70 years with coronary artery disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 FANG Lei , WANG Peishan , JIN Qilin , SHI Chuang , WANG Po

Department of Cardiac Surgery, Daxing Teaching Hospital, Capital Medical University, Beijing, 102600, P.R.China;

Corresponding author：

FANG Lei, Email: Fanglei868@163.com

Keywords：

Coronary heart disease; elderly patients; coronary artery bypass grafting

DOI：

10.7507/1007-4848.201812016

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical efficacy of coronary artery bypass grafting in the treatment of coronary artery disease patients aged over 70 years. Methods A total of 160 patients with coronary atherosclerotic heart disease underwent off-pump coronary artery bypass grafting from January 2013 to December 2017. There were 94 males and 66 females at age of 70–85 (76.67±2.33) years. Operations were performed by using sternal median incision with the assistance of local myocardial surface fixator and shunt plug, and the saphenous vein and internal mammary arterywere used as grafted vessels. Results All the patients were received successful off-pump coronary artery bypass grafting without death, and the cardiac function improved significantly. There were 62 patients with the internal mammary artery bridge and 98 patients with the whole vein bridge. All the patients were followed-up for 1 to 4 years. All the patients had obvious relief of angina pectoris. Conclusion Off-pump coronary artery bypass grafting for the treatment of elderly patients with coronary heart disease is an effective and safe operation, especially for patients with renal insufficiency, cerebrovascular disease, respiratory disease and severe left ventricular dysfunction.

Citation： FANG Lei, WANG Peishan, JIN Qilin, SHI Chuang, WANG Po. Clinical effect of off-pump coronary artery bypass grafting for the patients over 70 years with coronary artery disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(9): 879-883. doi: 10.7507/1007-4848.201812016 Copy

1.	Lamy A, Tong W, Devereaux PJ, et al. The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year. Ann Thorac Surg, 2014, 98(5): 1620-1625.
2.	Barandon L, Richehe P, Munos E, et al. Off-pump coronary artery bypass surgery in very high-risk patients: adjustment and preliminary result. Interact Cardiovasc Thorac Surg, 2008, 7: 789-793.
3.	Dalén M, Ivert T, Holzmann MJ, et a1. Long-term survival after off-pump coronary artery bypass surgery: a swedish nationwide cohort study. Ann Thorac Surg, 2013, 96(6): 2054-2060.
4.	Wu C, Camacho FT, Zhao S, et al. Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents. Ann Thorac Surg, 2013, 95(4): 1297-1305.
5.	Cgaudhry UA, Harling L, Rao C, et al. Off-pump versus on-pump coronary revascularization: meta-analysis of mid- and long-term outcomes. Ann Thorac Surg, 2014, 98(2): 563-572.
6.	Christian M, Stephen M, Christina V, et al. Trends in patient characteristics and outcomes of coronary artery bypass grafting in the 2000 to 2012 medicare population. Ann Thorac Surg, 2016, 102(1): 132-138.
7.	Lisboa LA, Mejia OA, Dallan LA, et a1. Which patients will benefit more from off-pump coronary artery bypass grafting? J Thorac Cardiovasc Surg, 2014, 147(1): 540-541.
8.	Damien J, Castigliano M, Bhamidipati, et al. Is off-pump coronary artery bypass grafting superior toconventional bypass in octogenarians? Thorac Cardiovasc Surg, 2011, 141(1): 81-90.
9.	Takahashi H, Okada K, Matsumori M, et al. Off-pump coronary artery by-pass grafting in an octogenarian with situs inversus and dextrocardia;report of a case. Surg Today, 2011, 41(8): 1130-1132.
10.	Baskett R, Cafferty F, Powell S, et al. Total arterial revasculariastion in safe:multicenter ten-year analysia of 71470 coronary procedures. Ann Thorac Surg, 2006, 81: 1243-1248.
11.	Dreifaldt M, Mannion JD, Bodin L, et al. The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting. Ann Thorac Surg, 2013, 96(1): 105-111.
12.	Ho Y, Kyung-Hak L, Jung W, et al. Equivalency of saphenous vein and arterial composite grafts: 5-year angiography and midterm clinical follow-up. Ann Thorac Surg, 2016, 102(2): 580-588.
13.	Mohammadi S, Dagenaia F, Doyle D, et al. Age cut-0ff for the loss of benefit from bilateral internal thoracic artery grafting. Eur J Cardiothocac, 2008, 33: 977-982.
14.	Kit V, Thomas F, Robert W, et al. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg, 2000, 69(3): 704-710.
15.	Tsutomu M, Shinsuke M, Tomohito K, et al. A safe technique for using an enclose ii anastomosis assist device during off-pump coronary bypass. Ann Thorac Surg, 2016, 102(6): 581-582.
16.	Vito M, Luigi D, Vincenzo D, et al. Preoperative intraaortic balloon pump for off-pump coronary arterial revascularization. Ann Thorac Surg, 2012, 96(3): 804-809.
17.	Benjamin D, Kozower M, Marc R, et al. Impact of complete revascularization on long-term survival after coronary artery bypass grafting in octogenarians. Ann Thorac Surg, 2005, 80(1): 112-117.
18.	Rossi M, Jiritano F, Malta E, Renzulli A, et al. Competitive flow between a vein and an arterial graft at transit-time flow measurement. Interact Cardiovasc Thorac Surg, 2012, 15(2): 288-289.
19.	Amin S, Werner RS, Madsen PL, et al. Intraoperative Bypass graft flow measurement with transit time flowmetry: a clinical assessment. Ann Thorac Surg, 2018, 106(2): 532-538.

1. Lamy A, Tong W, Devereaux PJ, et al. The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year. Ann Thorac Surg, 2014, 98(5): 1620-1625.
2. Barandon L, Richehe P, Munos E, et al. Off-pump coronary artery bypass surgery in very high-risk patients: adjustment and preliminary result. Interact Cardiovasc Thorac Surg, 2008, 7: 789-793.
3. Dalén M, Ivert T, Holzmann MJ, et a1. Long-term survival after off-pump coronary artery bypass surgery: a swedish nationwide cohort study. Ann Thorac Surg, 2013, 96(6): 2054-2060.
4. Wu C, Camacho FT, Zhao S, et al. Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents. Ann Thorac Surg, 2013, 95(4): 1297-1305.
5. Cgaudhry UA, Harling L, Rao C, et al. Off-pump versus on-pump coronary revascularization: meta-analysis of mid- and long-term outcomes. Ann Thorac Surg, 2014, 98(2): 563-572.
6. Christian M, Stephen M, Christina V, et al. Trends in patient characteristics and outcomes of coronary artery bypass grafting in the 2000 to 2012 medicare population. Ann Thorac Surg, 2016, 102(1): 132-138.
7. Lisboa LA, Mejia OA, Dallan LA, et a1. Which patients will benefit more from off-pump coronary artery bypass grafting? J Thorac Cardiovasc Surg, 2014, 147(1): 540-541.
8. Damien J, Castigliano M, Bhamidipati, et al. Is off-pump coronary artery bypass grafting superior toconventional bypass in octogenarians? Thorac Cardiovasc Surg, 2011, 141(1): 81-90.
9. Takahashi H, Okada K, Matsumori M, et al. Off-pump coronary artery by-pass grafting in an octogenarian with situs inversus and dextrocardia;report of a case. Surg Today, 2011, 41(8): 1130-1132.
10. Baskett R, Cafferty F, Powell S, et al. Total arterial revasculariastion in safe:multicenter ten-year analysia of 71470 coronary procedures. Ann Thorac Surg, 2006, 81: 1243-1248.
11. Dreifaldt M, Mannion JD, Bodin L, et al. The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting. Ann Thorac Surg, 2013, 96(1): 105-111.
12. Ho Y, Kyung-Hak L, Jung W, et al. Equivalency of saphenous vein and arterial composite grafts: 5-year angiography and midterm clinical follow-up. Ann Thorac Surg, 2016, 102(2): 580-588.
13. Mohammadi S, Dagenaia F, Doyle D, et al. Age cut-0ff for the loss of benefit from bilateral internal thoracic artery grafting. Eur J Cardiothocac, 2008, 33: 977-982.
14. Kit V, Thomas F, Robert W, et al. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg, 2000, 69(3): 704-710.
15. Tsutomu M, Shinsuke M, Tomohito K, et al. A safe technique for using an enclose ii anastomosis assist device during off-pump coronary bypass. Ann Thorac Surg, 2016, 102(6): 581-582.
16. Vito M, Luigi D, Vincenzo D, et al. Preoperative intraaortic balloon pump for off-pump coronary arterial revascularization. Ann Thorac Surg, 2012, 96(3): 804-809.
17. Benjamin D, Kozower M, Marc R, et al. Impact of complete revascularization on long-term survival after coronary artery bypass grafting in octogenarians. Ann Thorac Surg, 2005, 80(1): 112-117.
18. Rossi M, Jiritano F, Malta E, Renzulli A, et al. Competitive flow between a vein and an arterial graft at transit-time flow measurement. Interact Cardiovasc Thorac Surg, 2012, 15(2): 288-289.
19. Amin S, Werner RS, Madsen PL, et al. Intraoperative Bypass graft flow measurement with transit time flowmetry: a clinical assessment. Ann Thorac Surg, 2018, 106(2): 532-538.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical effect of off-pump coronary artery bypass grafting for the patients over 70 years with coronary artery disease

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