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Myocardial revascularization without extracorporeal circulation in patients over 75 years of age: analysis of immediate results

OBJECTIVE: To assess the immediate results of myocardial revascularization surgery without extracorporeal circulation in a group of patients over 75 years of age. METHODS: From January 2001 to December 2003, 193 (121 men and 72 women) patients with ages ranging from 75 to 94 years, corresponding to 100% of the coronary surgeries performed in patients over the age of 75 years, underwent myocardial revascularization without extracorporeal circulation. Their hospitalization data were retrospectively analyzed. RESULTS: Arterial hypertension was present in 174 (90%), dyslipidemia in 115 (59%), smoking in 89 (46%), and diabetes in 57 (29%). Ninety-six (49.7%) patients had had a previous myocardial infarction, 53 of whom (27.4%) had experienced an acute ischemic event in a period < 30 days after surgery. Critical obstructive lesions in 3 or more coronary vessels were present in 156 (80.95%) patients, while 30 (15%) patients had an important obstruction of the left main coronary artery, and 30 (15%) patients had an ejection fraction < 30%. The score obtained according to the EUROSCORE ranged from 3 to 18, with an expected mortality rate for the group of 7.54±2.69%. The total number of distal anastomoses was 639. Seven (3.62%) patients died, 3 due to bronchopneumonia, 1 due to mediastinitis, 1 due to metabolic causes, 1 due to cardiogenic shock, and another died suddenly after refixation of a sternal dehiscence. Reoperation due to bleeding, orotracheal reintubation, and prolonged mechanical ventilation were factors associated with an increase in mortality. CONCLUSION: The surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital.

elderly; myocardial revascularization surgery; extracorporeal circulation


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