[Single clamp technique in elderly patients undergoing coronary artery surgery].

Objective: The results of single clamp and partial clamp techniques were retrospectively compared in elderly patients (>70 years) undergoing coronary artery bypass grafting operation (CABG).

Methods: A total of 244 elderly patients undergoing CABG between January 1995 and March 2002 in our center were studied. Single-clamp technique was used in 32 cases (Group 1) and partial-clamp technique was used in 212 cases (Group 2). All patients had isolated coronary artery lesions and a primary elective coronary bypass grafting surgery was planned for every case. Preoperative, operative and postoperative variables; age, gender, pre- and post-operative neurological status (stroke, amaurosis fugax, aphasia, hemiplegia, hemiparesis), cerebrovascular diseases, diabetes mellitus, hypertension, number of distal grafts, left ventricular score, durations of aortic cross-clamping and cardiopulmonary bypass (CPB) times, perfusion pressure during CPB, and postoperative cardiac status were recorded. Patients with a history of neurological complications were excluded from the study.

Results: Overall, mean age was 71.9+/-2.18 years. Patients in Group 1 were significantly older as compared to patients in Group 2 (p< 0.01). Average duration of cross-clamping in Group 1 was significantly longer (p<0.001) compared to Group 2, but there were no differences with regard to the total duration of cardiopulmonary bypass (p=0.535). No patients had neurological complications in Group 1, however 22 patients in Group 2 had neurological complications (p<0.05).

Conclusion: Although single-clamp technique was associated with a longer cross-clamp time, the duration of CPB was not increased and the incidence of neurological complications was low.