Our results did not reveal a significant benefit of either surgical technique with respect to early-term clinical outcomes in elderly CABG patients. Further investigations are needed to determine whether off-pump CABG is superior than on-pump CABG in elderly patients.

ObjectiveTo investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery.MethodsBetween October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed.ResultsGroup 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups.ConclusionIn conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.

SummaryObjectiveOur aim was to compare short-term outcomes and long-term major adverse cardiovascular event (MACE)-free survival and independent predictors of long-term MACE after off-pump (OPCAB) versus on-pump beating-heart (ONBHCAB) coronary artery bypass grafting (CABG).MethodsWe retrospectively reviewed data of all consecutive patients who underwent elective CABG, performed by the same surgeon, from January 2003 to October 2009. A propensity score analysis was carried out to adjust for baseline characteristics and a total of 398 patients were included: ONBHCAB (n = 181), OPCAB (n = 217).ResultsOPCAB was associated with significantly shorter ventilation times (p < 0.001), intensive care unit stay (p < 0.001) and hospital stay (p < 0.001). The total blood loss was significantly more in the ONBHCAB group (p < 0.001), and accordingly, the number of transfused blood units was significantly lower in the OPCAB group (p < 0.001). Incidence of peri-operative renal complications were significantly higher in the ONBHCAB group (p = 0.004). The OPCAB group showed significantly lower long-term MACE-free survival (p = 0.029). The mean number of transfused blood units was the only independent predictor of MACE (HR: 1.218, 95% CI: 1.089–1.361; p = 0.001).ConclusionOPCAB provided better long-term MACE-free survival compared with ONBHCAB. Fewer units of blood transfused following OPCAB surgery may have been the main reason for this result.

PurposeTo evaluate the corkscrew collaterals in Buerger's disease by superb microvascular imaging (SMI) and power Doppler ultrasonography (PDU).MethodsWe evaluated with SMI and PDU 14 patients with Buerger's disease in whom corkscrew collaterals had been identified on digital subtraction angiography (DSA). Corkscrew collaterals were classified on DSA and PDU based on their size and morphology.ResultsA total of 17 vascular regions of collateral vessel formation were assessed. Based on DSA classification, there were three cases of type I collaterals (arterial diameter of >2 mm with large helical pattern), seven cases of type III collaterals (arterial diameter of 1‐1.5 mm with small helical pattern), and seven cases of type IV collaterals (arterial diameter of <1 mm with tiny helical pattern). On PDU, all type I collaterals on DSA appeared as “large snake” images, all type III collaterals on DSA appeared as “small snake” images, and all type IV collaterals on DSA appeared as dots. SMI imaging, both in color and monochrome mode, provided superior demonstration of the continuity of the vessel of large or small “snake” images. In cases appearing as dot pattern on PDU, color SMI was able to show continuity of the flow signal as a helical pattern.DiscussionSMI is a promising new Doppler imaging technique that is superior to conventional power Doppler imaging in depiction and identification of corkscrew collaterals in Buerger's disease.

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