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ABSTRACT 30
OFF PUMP CORONARY SURGERY IN THE ELDERLY
Wen Cheng, MD, Tim Denton, MD, and Alfredo Trento, MD.
Cedars-Sinai Medical Center, Los Angeles, California, USA
Objectives: Off-pump coronary surgery (OPCS) may benefit
elderly patients compared to standard coronary artery bypass surgery
(CABG).
Methods: Between 3/15/95 and 10/20/00, 2389 patients
had CABG and 374 had OPCS (347 via sternotomy, 27 via anterior
thoracotomy). The risk of surgical mortality was estimated using
the Northern New England (NNE) risk model.
Results: * p<.001; all other comparisons non-significant.
| Age by decade |
<60 |
60 |
70 |
80 |
90 |
Overall |
|
N CABG
OPCS
|
543
70
|
666
86
|
905
131
|
270
76
|
5
11
|
2389
374
|
|
Stroke (%)
|
1.1
0
|
2.1
0
|
3.8
3.8
|
3.0
1.3
|
0
9.1
|
2.6
1.9
|
|
Mortality(%)
|
1/3
0
|
2.4
1.2
|
2.4
1.5
|
5.2
7.9
|
0
27.3
|
2.5
3.5
|
|
NNE risk (%)
|
2.3
2.1
|
4.6
4.9
|
8.1*
10.9
|
13.9
14.5
|
19.6
27.6
|
6.4*
9.2
|
The NNE estimated risk was higher in the off-pump coronary surgery
group (p<.001). However, the observed mortality and stroke
rate were comparable between the off-pump coronary surgery group
and the standard coronary surgery group.
Conclusion: OPCS can be used in the higher risk
elderly population with at least equivalent mortality and stroke
incidence compared to conventional CABG.
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