Mid- and Long-Term Outcomes of Total Arterial Myocardial Revascularization in Patients Aged 70 Years and Older: A Single-Center Experience.

Background:  Patients receiving arterial grafts have superior late survival after coronary artery bypass graft (CABG) surgery. The aim of our study was to evaluate the mid- and long-term results of total arterial (TA) revascularization in the elderly.

Methods:  Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed. Altogether, 356 patients who received isolated CABG were assigned to either TA group or control (CON) group.

Results:  No significant differences were noted in regard to preoperative risk factors. The number of distal anastomoses was significantly higher in the CON group (3.6 ± 0.6 vs. 2.9 ± 0.8;  < 0.001). Postoperatively, no significant differences were noted in regard to morbidity or mortality. There were no significant differences in mortality rate at 1 year (5.6 vs. 5.2%;  = 0.98), or 5 years (9.0 vs. 12.1%;  = 0.39) between both groups. However, the TA group was associated with significantly higher rate of event-free survival ( = 0.017).

Conclusion:  This study suggests that TA revascularization is an effective procedure. Lower rates of late cardiac events encourage the use of this concept for the elderly.