Aortic Calcification Presents Increased CABG Risk In Octogenarians

MedicalResearch.com Interview with:
Salah Altarabsheh, MD,MRCSI
Cardiac Surgery Senior Specialist
Queen Alia Heart Institute Amman, Jordan

Coronary artery bypass grafting is the most common surgical procedure performed by cardiac surgeons worldwide. With the increased life expectancy for the general population, and the added comorbidities among elderly population, we are seeing a good number of elderly populations who are referred for coronary artery bypass surgery. There are few reports which compare off-pump versus on-pump methods of revascularization among this subset of elderly people. We choose octogenarians in our meta-analysis to see whether off-pump revascularization method could be of benefit since there is increased chance to have ascending aortic calcifications among these patients, and off-pump coronary artery bypass in which there is lesser chance for aortic manipulations, can be beneficial.

Early adverse outcomes were compared between the two methods of revascularization, and despite the fact that there were lesser grafts in the off-pump method compared to the on-pump method, however there was lesser chance to develop stroke in patients who had off-pump technique.

Other early outcomes like: Early mortality, Myocardial infarction, Respiratory failure and atrial fibrillation were almost comparable between the two methods.

We think that, coronary artery bypass grafting in octogenarians especially in the presence of calcified ascending aorta, should alert cardiac surgeons to pay more attention to decrease manipulations of the ascending aorta, and the risk of stroke in these patients could outweighs the benefits of complete revascularization in this subset of patients.

A future randomized controlled trial may be of great benefit in this field; however, in the absence of these trials, a detailed meta-analysis may be an alternative tool to drive conclusions.

Citation:

Coronary Artery Bypass Grafting After Percutaneous Intervention Has Higher Early Mortality: A Meta-Analysis
Altarabsheh, Salah E. et al.

The Annals of Thoracic Surgery Published Online: April 09, 201

DOI: http://dx.doi.org/10.1016/j.athoracsur.2014.12.073

 

MedicalResearch.com Interview with:, & Salah Altarabsheh, MD,MRCSI (2015). Aortic Calcification Presents Increased CABG Risk In Octogenarians