Complete arterial revascularization with both internal thoracic mammary arteries improves peri-operative and mid term survival in off pump CABG in octogenerians with 3 vessel disease: A follow-up study

Introduction: We are currently studying the peri-operative and mid-term results of complete arterial revascularization using OPCAB in octogenarians with 3 vessel disease, who were operated in our centre. Complete arterial revascularization implicated that we used both Internal Mammary Arteries as bypass grafts. These data were compared with those obtained from a group of patients who were treated with one IMA and vein grafts only in OPCAB surgery. The patients of the control group were comparable to the patients of the total arterial group in regard to age, sex, diabetes and period of operation.

Methods: Between 1997 and 2005, 32 octogenarians underwent total arterial revascularization using the OPCAB technique. The Control group existed of 46 patients. We analysed peri-operative and mid term all cause mortality, myocardial infarction and re-intervention rates (PCI or redo-CABG) up to 9 years after the first operation by telephone interviews of the patients and studying the medical files of the referring cardiologist or general practitionars.

Results: Currently, we have completed the follow-up of 78 patients. Median follow-up time was 5 years (90% mid range 1–8 years). Event free survival was significantly higher in the total arterial group as compred to the control group (HR 1.5, 95% CI 1.0–2.2 p=0.045).

Conclusion: Mortality, Myocardial Infarction, Re-intervention rates and return of Angina are significantly better after total arterial revascularization.