Impact of advanced age on peri-operative effect of off-pump coronary artery bypass grafting

Zhang Ren-teng; Jiang Hui; Wang Hui-shan; Zhou Nan; Yang Zhong-lu; Gao Hao

doi:10.13498/j.cnki.chin.j.ecc.2015.01.11

Abstract：Objective To analyze the impact of advanced age on peri-operative curative effect of off-pump coronary artery by?pass grafting. Methods 53 patients at the age of 75-86 ( elderly group) and 585 patients under 65 years old ( youg group) who con?tinuously accept off-pump coronary artery bypass graft surgery from August 2013 to April 2014 in our hospital were reviewed. The peri-operative clinical parameters of the two groups were compared and analyzed. Results 1. In the intraoperative data, such as anasto?mosis time of target coronary artery and dosage of the vasoconstrictor drugs, the elderly group was significantly higher than young group. In incidence of the post-operative complications, such as arrhythmias, respiratory dysfunction, gastrointestinal dysfunction, and short-term renal insufficiency, the elderly group was significantly higher than the young group. No significant difference between the two groups in cerebral vascular accident, ardiac vascular accident and peri-operative mortality. 2. Multivariate logistic regression analysis revealed the independent risk factors for target vessel anastomosis time, intraoperative vasoconstrictor drug dosage, time of tracheal can?nula and post-operative complications such as repeated mechanical ventilation, atrial fibrillation and gastrointestinal dysfunction. 3. The above complications were all independent risk factors of prolonged post-operative hospitalization of elderly patients. Conclusion For elderly patients, the effect of off-pump coronary artery bypass grafting was satisfactory. Cardiovascular accident, cerebral vascular accident and mortality did not increase in the elderly group. However, the ability to tolerate operation stimulation was poor in the elderly patients, and careful anesthetic management was necessary. Post-operative arrhythmia, respiratory insufficiency and gastrointestinal dysfunction were more likely to occur in the elderly patients, which prolonged post-operative hospitalization of elderly patients, and more positive ideas and coping strategy should be taken.