Aorta No-Touch Off-Pump Coronary Artery Revascularization in Octogenarians: 5 Years' Experience

Prapas, Sotirios; Panagiotopoulos, Ιoannis; Pentchev, Dimitar N.; Ayyad, Mohamed A. Salama; Protogeros, Dimitrios; Kotsis, V.; Linardakis, Ioannis N.; Tzanavaras, Theofanis P.; Stratigi, Poly T.

doi:10.1532/hsf98.20091125

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…Furthermore, hybrid conduit techniques, such as the application of T-or Y-grafts and bilateral internal mammary arteries (BIMA), offer innovative solutions for specific clinical cases. These insights can aid surgeons in making informed decisions, leading to improved patient outcomes and long-term success of coronary artery bypass surgery [26][27][28][29][30].…”

Section: Choices Of Graftsmentioning

confidence: 99%

The choice of conduits in coronary artery bypass surgery

Panagiotopoulos,

Leivaditis,

Sawafta

et al. 2023

Arch Med Sci Atheroscler Dis

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Choosing appropriate bypass conduits is important in the consideration of long-term outcomes after surgical revascularization. When deciding on a grafting strategy, attention should be given to technical, anatomic, and angiographic determinants of conduit properties, as well as the clinical characteristics of the patient. The aim of the study was to present a current review of available choices of conduits in coronary artery bypass surgery. To date, only 4 conduits have proven to be effective: the saphenous vein (SVG), the internal mammary arteries (IMAs), the radial artery (RA), and the right gastroepiploic artery (RGEA). The IMA has unique biological properties that confer protection to intimal growth and atherosclerotic plaque formation, making it the conduit of choice for coronary artery bypass grafting. SVG exhibits a lower patency rate than those of IMAs. The RGEA allows revascularization of the inferior wall but is less commonly used, given that it is more prone to spasms.

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Section: Choices Of Graftsmentioning

confidence: 99%

The choice of conduits in coronary artery bypass surgery

Panagiotopoulos,

Leivaditis,

Sawafta

et al. 2023

Arch Med Sci Atheroscler Dis

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Cardiac Surgery

Edwards

Bennetts

Coventry

2013

Cardio-Thoracic, Vascular, Renal and Transplant Surgery

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Bilateral internal thoracic artery grafting in octogenarians: where are the benefits?

et al. 2015

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The use of bilateral internal thoracic artery (BITA) grafting for myocardial revascularization is usually discouraged in the very elderly because of increased risk of perioperative complications. The aim of the study was to analyze early and late outcomes of BITA grafting in octogenarians. From January 1999 throughout February 2014, 236 consecutive octogenarians with multivessel coronary artery disease underwent primary isolated coronary bypass surgery at the authors' institution. Six of these patients underwent emergency surgery and were excluded from this retrospective study; consequently, 135 BITA patients were compared with 95 single internal thoracic artery (SITA) patients according to early and late outcomes. Between BITA and SITA patients, there was no significant difference in the operative risk (EuroSCORE II: 8 ± 7.7 vs. 7.6 ± 6.1 %, p = 0.65). There was a lower aortic manipulation in BITA patients. Hospital mortality (3 vs. 4.2 %, p = 0.44) and perioperative complications were similar except that only BITA patients experienced sternal wound infection (5.2 %, p = 0.022). The mean follow-up was 4.7 ± 3.3 years. There were no differences between the two groups in overall survival (p = 0.79), freedom from cardiac and cerebrovascular deaths (p = 0.73), major adverse cardiac and cerebrovascular events (p = 0.63) and heart failure hospital readmission (p = 0.64). Predictors of decreased late survival were diabetes (p = 0.0062) and congestive heart failure (p = 0.0004). BITA grafting can be routinely used in octogenarians with atherosclerotic ascending aorta without an increase in hospital mortality or major adverse cardiac and cerebrovascular complications. However, there is an increased risk of sternal wound infection without a demonstrable long-term benefit.

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Aorta No-Touch Off-Pump Coronary Artery Revascularization in Octogenarians: 5 Years' Experience

Abstract: Use of the pi-circuit technique is very effective for octogenarians. Although these older patients have a higher incidence of early postoperative morbidity, overall survival is not affected.

Cited by 3 publications

References 20 publications

The choice of conduits in coronary artery bypass surgery

The choice of conduits in coronary artery bypass surgery

Cardiac Surgery

Bilateral internal thoracic artery grafting in octogenarians: where are the benefits?

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