COMPLETE ARTERIAL REVASCULARISATION IN ELDER PATIENTS

Abstract

Aim: The aim of this study was to evaluate the early and mid-term results of total arterial myocardial revascularization in elderly patients. Material and Method: 65 patients aged 60 years and older (mean 64.8+5.4, range 60-78 years) who underwent total arterial myocardial revascularization between January 2002 and June 2004 were evaluated prospectively. 41 patients (63.1%) had three-vessel coronary artery disease, 18(27.7%) had two-vessel disease and 6(9.2%) with left main lesion. 22 patients had an old myocardial infarction and 11 unstabile angina pectoris. Mean EF was 55%. All patients underwent TAMR. In total 167 distal anastomoses were constructed (2.6 per patient) Pedicled LITA and RITA, free RITA and Radial arter were used as single or composite T-or Y- graft. Results: Patient were followed-up in a mean period of 17.6+7.3 months (range 1-28 month). There was no ocluded grafts in the early postoperative period (less than 90 days) patency 100%. Late(mean 16+2 month) LITA patency was 98.1% (one graft ocluded), RITA patency was 93.4% (one graft ocluded) and RA patency was 93.2% (three grafts ocluded).One patient died in this period (1.5%) one underwent PTCA (1.5%) two suffered angina pectoris (3.1%), there was no reoperation in this period. Conclusion: This study showed that using only arterial conduits in coronary bypass surgery in elderly (patient aged over 60 years) were clearly evident with respect to higher patency rate, surgical reintervention and freedom from cardiac events.

Keywords

• FARUK CINGÖZ

COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS

Abstract

Aim: The aim of this study was to evaluate the early and mid-term
results of total arterial myocardial revascularization in elderly
patients.
Material and Method: 65 patients aged 60 years and older (mean
64.8+5.4, range 60-78 years) who underwent total arterial myocardial revascularization between January 2002 and June 2004 were
evaluated prospectively. 41 patients (63.1%) had three-vessel coronary artery disease, 18(27.7%) had two-vessel disease and 6(9.2%)
with left main lesion. 22 patients had an old myocardial infarction
and 11 unstabile angina pectoris. Mean EF was 55%. All patients
underwent TAMR. In total 167 distal anastomoses were constructed
(2.6 per patient) Pedicled LITA and RITA, free RITA and Radial
arter were used as single or composite T-or Y- graft.
Results: Patient were followed-up in a mean period of 17.6+7.3
months (range 1-28 month). There was no ocluded grafts in the
early postoperative period (less than 90 days) patency 100%.
Late(mean 16+2 month) LITA patency was 98.1% (one graft ocluded), RITA patency was 93.4% (one graft ocluded) and RA patency
was 93.2% (three grafts ocluded).One patient died in this period
(1.5%) one underwent PTCA (1.5%) two suffered angina pectoris
(3.1%), there was no reoperation in this period.
Conclusion: This study showed that using only arterial conduits in
coronary bypass surgery in elderly (patient aged over 60 years) were
clearly evident with respect to higher patency rate, surgical reintervention and freedom from cardiac events.

Keywords

• COMPLETE
• ARTERIAL
• REVASCULARISATION

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