Survival benefit from a second arterial conduit to the circumflex circulation persists in elderly after coronary artery bypass surgery.

Autor:	Luthra S; Division of Cardiac Surgery, University Hospital Southampton, Hampshire, UK., Leiva-Juárez MM; Department of Surgery, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA., Malvindi PG; Division of Cardiac Surgery, University Hospital Southampton, Hampshire, UK., Billing JS; Department of Cardiothoracic Surgery, New Cross Hospital, West Midlands, UK., Ohri SK; Division of Cardiac Surgery, University Hospital Southampton, Hampshire, UK.
Jazyk:	angličtina
Zdroj:	Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2021 Nov; Vol. 29 (9), pp. 910-915. Date of Electronic Publication: 2021 Feb 22.
DOI:	10.1177/0218492321997077
Abstrakt:	Background: This retrospective propensity matched study investigated the impact of age on the survival benefit from a second arterial conduit to the left-sided circulation. Methods: Data for isolated coronary artery bypass surgery were collected from October 2004 to March 2014. All patients with an internal mammary artery graft to left anterior descending artery and additional arterial or venous graft to the circumflex circulation were included. Propensity matching was used to balance co-variates and generate odds of death for each observation. Odds ratios (venous vs. arterial) were charted against age. Results: The in-hospital mortality rate was 1.12% (arterial) vs. 1.24% (venous) (p = 0.77). The overall 10-year survival was 74.6% (venous) vs. 82.6% (arterial) (p = 0.001). A total of 1226 patients were successfully matched to the venous or arterial (second conduit to circumflex territory after left internal mammary artery to left anterior descending artery) cohorts. Odds ratio for death (venous to arterial) showed a linear decremental overall survival benefit for the second arterial graft to circumflex circulation with increasing age. Conclusions: The survival benefit of a second arterial graft persists through all age groups with a gradual decline with increasing age over the decades. Elderly patients should not be denied a second arterial graft to the circumflex circulation based on age criterion alone.
Databáze:	MEDLINE
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