Coronary artery bypass surgery in elderly people

Natarajan, Arun; Samadian, Samad; Clark, Stephen

doi:10.1136/pgmj.2006.049742

Cited by 81 publications

(84 citation statements)

References 37 publications

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“…Rev Bras Cir Cardiovasc 2011; 26.1: [21][22][23][24][25][26] In this study, it was also described that the mortality chance during hospitalization of an 80-year-old patient, in multivariate analysis, was 3.25 times the chance of a 50-year-old patient.…”

Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 88%

“…Salomon et al [19] demonstrated in a 6-year follow-up period a percentage of angina-free survival of 77% and Mullany et al [20], in a 5-year follow-up period with 159 patients over 80 years old, observed a percentage of 79%. The excellent long-term survival in elderly patients after the completion of the CABG may be accompanied by a satisfactory quality of life in most patients [21].…”

Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 99%

“…There are no universal criteria accepting the selection or rejecting the patients for surgery: an elderly with few comorbidities and a good expected quality of life and life expectancy, will probably benefit from CABG. On the other hand, an octogenarian with several comorbidities and a suboptimal expected quality of life after surgery should probably be better managed conservatively [21]. Conforming to the ACC / AHA guidelines [10], the preoperative variables associated with shorter survival in elderly patients include atrial fibrillation, smoking, peripheral vascular disease and low renal function.…”

Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 99%

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Sobrevida em longo prazo de octogenários submetidos à cirurgia de revascularização miocárdica isolada

Júnior¹,

Valle²,

Pereira³

et al. 2011

Rev Bras Cir Cardiovasc

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Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 88%

Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 99%

Section: Pivatto Junior F Et Al -Long-term Survival Of Octogenarian mentioning

confidence: 99%

See 1 more Smart Citation

Sobrevida em longo prazo de octogenários submetidos à cirurgia de revascularização miocárdica isolada

Júnior¹,

Valle²,

Pereira³

et al. 2011

Rev Bras Cir Cardiovasc

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“…28 In the case of CABG, intraoperative or postoperative MI, low cardiac output syndrome, stroke, gastrointestinal complications, wound infection and renal failure occur more frequently in elderly patients after cardiac surgery and predict adverse outcomes. 29 Accordingly, aggressive revascularization in elderly patients with CTO should be carefully determined under consideration of lesion characteristics, physiological age and physical activity.…”

Section: Disclosures/competing Interests/grant Supportmentioning

confidence: 99%

Long-Term Clinical Outcomes of Medical Therapy for Coronary Chronic Total Occlusions in Elderly Patients (≥75 Years)

Lee

Yang

Choi

et al. 2015

Circ J

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Background: Limited data are available on the clinical outcomes of medical therapy (MT) compared with revascularization in elderly patients with coronary chronic total occlusion (CTO). Methods and Results:Between March 2003 and February 2012, we retrospectively analyzed 311 patients aged ≥75 years in the Samsung Medical Center CTO registry. Among these, 153 patients were treated with MT and 158 patients with revascularization by intervention or surgery. Inverse probability of treatment weighting (IPTW) and propensity score-matching were performed. The primary outcome was cardiac death during follow-up. Median followup duration was 34 (interquartile range: 15-58) months. Overall, patients in the MT group were high-risk subjects. Cardiac death of 30 patients (19.6%) occurred in the MT group vs. 17 patients (10.8%) in revascularization group (P=0.027). In the multivariate analysis, there was no significant difference between groups in the rate of cardiac death (hazard ratio [HR], 1.67; 95% confidence interval [CI], 0.86-3.24, P=0.13). After adjustment with IPTW, MT showed comparable risk of cardiac death with revascularization therapy (HR, 1.26; 95% CI, 0.71-2.21, P=0.43). In the propensity score-matched population, there was no significant difference in the rate of cardiac death between the MT and revascularization groups (HR, 1.52; 95% CI, 0.76-3.07, P=0.24). Conclusions:In the treatment of CTO in elderly patients, MT alone did not increase the risk of long-term cardiac death when compared with aggressive revascularization treatment. (Circ J 2015; 79: 1780 -1786

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“…Coronary artery bypass grafting (CABG) is the gold standard intervention in patients with complex multivessel disease [3]. In the UK, there are about 25,000 CABG operations performed annually [4] and the majority of these operations is carried out on patients over 70 years of age [5]. Demand for CABG is likely to increase considerably in the future as a result of rapidly ageing populations [6] and increased expectations of patients and surgeons to expand their indications for surgery.…”

Section: Coronary Artery Bypass Grafting (Cabg)mentioning

confidence: 99%

http://oatext.com/Dual-antiplatelet-therapy-after-coronary-artery-bypass-grafting-Do-we-have-a-consensus.php

Jaaly¹,

Zakkar²,

Pufulete³

et al. 2015

J Integr Cardiol

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Coronary artery bypass grafting (CABG) remains the gold standard treatment in patients with complex multivessel coronary artery disease (CAD). Reversed long saphenous vein is the most commonly used conduit despite the known early thrombotic failure and low long-term patency rate. Post-operative antiplatelet therapy is an established treatment to improve graft patency and also a secondary treatment of the underlying native CAD.Aspirin has traditionally been the first line therapy; however, aspirin resistance especially in the early period after CABG, has been reported over the years and as a result, the use of dual antiplatelet therapy (DAPT) has become more common. However, there is limited evidence about the effect of DAPT and duration of use after CABG on graft patency, clinical outcomes (such as bleeding and myocardial infarction), and survival. The optimal dose of aspirin when given in DAPT is unclear and the duration of DAPT in association with quality of life is unknown.Furthermore, a better understanding of the pathology of vein graft disease and how available drugs influence it, could lead to the development of customised therapy for cohorts of patients undergoing CABG with potential benefits to early and long term outcomes. Here we review the available evidence on the routine use of DAPT after CABG. Coronary artery bypass grafting (CABG)Ischaemic heart disease (IHD) is the main leading cause of death in the world, with 7.4 million deaths in 2012 [1,2]. Coronary artery bypass grafting (CABG) is the gold standard intervention in patients with complex multivessel disease [3]. In the UK, there are about 25,000 CABG operations performed annually [4] and the majority of these operations is carried out on patients over 70 years of age [5]. Demand for CABG is likely to increase considerably in the future as a result of rapidly ageing populations [6] and increased expectations of patients and surgeons to expand their indications for surgery.During the early years of coronary surgery, saphenous vein grafts (SVGs) were the only conduits used [7]. Over the years different arterial conduits were introduced with variable degree of success [8][9][10]. Contemporary data on international use of grafts are available from the SYNTAX trial that included 1541 patients who underwent CABG at 85 sites in 18 countries between 2005 and 2007 [11]. The SYNTAX trial confirmed that the long saphenous vein (LSV) graft, is the most used conduit for multivessel revascularisation, despite its known low early and late patency rates.The underlying mechanism behind vein graft disease is multifactorial and can include conduit trauma/graft thrombosis (within 1 month, early failure), activation of intimal hyperplasia associated with harvest and implantation into the arterial high-pressure system (1 to 12 months, intermediate failure), superimposed atherosclerosis (beyond 12 months, late failure) [12][13][14][15]. A prospective cohort study of 1,388 patients carried out between 1969 to 1994, in which patency was assessed using coronary...

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Coronary artery bypass surgery in elderly people

Cited by 81 publications

References 37 publications

Sobrevida em longo prazo de octogenários submetidos à cirurgia de revascularização miocárdica isolada

Sobrevida em longo prazo de octogenários submetidos à cirurgia de revascularização miocárdica isolada

Long-Term Clinical Outcomes of Medical Therapy for Coronary Chronic Total Occlusions in Elderly Patients (≥75 Years)

http://oatext.com/Dual-antiplatelet-therapy-after-coronary-artery-bypass-grafting-Do-we-have-a-consensus.php

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