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Internal thoracic artery for coronary artery grafting in octogenarians
Journal article   Open access   Peer reviewed

Internal thoracic artery for coronary artery grafting in octogenarians

R J Morris, M D Strong, K E Grunewald, M L Kuretu, L E Samuels, J Y Kresh and S K Brockman
The Annals of thoracic surgery, v 62(1), pp 16-22
Jul 1996
DOI: https://doi.org/10.1016/0003-4975(96)00252-4
PMID: 8678636
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/0003-4975(96)00252-4View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Age Distribution Coronary Artery Bypass - methods Follow-Up Studies Hospital Mortality Saphenous Vein - transplantation Humans Risk Factors Male Survival Rate Postoperative Complications - epidemiology Coronary Disease - mortality Morbidity Thoracic Arteries - transplantation Coronary Artery Bypass - mortality Time Factors Aged, 80 and over Female Aged Retrospective Studies Coronary Disease - surgery Length of Stay - statistics & numerical data Cohort Studies
Use of the left internal thoracic artery as a bypass graft has been shown to result in better long-term patency and improved survival. In elderly patients, the internal thoracic artery has been used less often for coronary artery bypass grafts because of the belief that greater morbidity and mortality are associated with this procedure. This study was undertaken to test this premise in the octogenarian population. Over an 8-year period, 474 consecutive patients 80 years of age and greater had coronary artery bypass grafting. The left internal thoracic artery was used in 188 patients (39.7%) (group 1) and saphenous vein grafts only (group 2), in 286 (60.3%). The mean age was 82.6 years (range, 80 to 95 years). There were 312 men (65.8%) and 162 women (34.2%). Use of the internal thoracic artery as a graft has risen steadily each year, as has the number of patients who are octogenarians. The hospital mortality rate was 7.8%. Patients in group 1 had a mortality rate of 9.0% and patients in group 2, a mortality rate of 7.0%. The mortality rate among survivors at 1 year was 6.7%. Long-term survival was significantly greater in group 1. On the basis of this study, we conclude that the internal thoracic artery is the bypass graft of choice, especially in regard to long-term mortality, and should not be denied to this high-risk group.

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59 citations in Web of Science
68 citations in Scopus

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Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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