Usage of left internal thoracic artery in the patients aged over 70 years during coronary artery bypass graft / 中华胸心血管外科杂志

ABSTRACT

Objective To review the outcome of coronary artery bypass grafting (CABG) using left internal thoracic artery (LITA) grafts in these patients aged more than 70 years old.Methods 1471 patients aged more than 70 years old[mean (73.3 ± 3.9) years] from July 2010 through August 2012,who underwent CABG in Anzhen hospital,form the cohort of this study.Among them,1395 cases underwent off-pump CABG,while 76 cases underwent on-pump CABG which includes onpump beating heart CABG in 12 cases.The average number of the grafts is 3.12 ±0.68.All of the patients were divided into two groups on base of the graftGroup Aonly saphenous vein graft was used in 564 cases; Group BThe left internal thoracic artery to the left anterior descending artery was used in 907 cases,which also include total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 42 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.12％ in group A and 2.09％ in group B.There was no significance between the 2 groups.The volume of blood drainage was larger in group B than that in group A.At the same time,there was no significance in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of IABP between the 2 groups.Conclusion It did not increase the mortality and morbidity of serious complications using the left internal thoracic artery to the left anterior descending artery in those elderly patients aged more than 70 years old during the CABG operation.With consideration of the obvious advantages in the long term patency,LITA was proposed to be used in CABG even in those age ＞ 70 patients.