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Open Access Research article

Short term outcomes of total arterial coronary revascularization in patients above 65 years: a propensity score analysis

Wael Hassanein1*, Yasser Y Hegazy1, Alexander Albert2, Ina C Ennker1, Ulrich Rosendahl1, Stefan Bauer1 and Juergen Ennker1

Author Affiliations

1 Cardiac Surgery Department, Heart Institute Lahr/Baden - Germany

2 Clinic of Cardiovascular Surgery, Duesseldorf University Hospital - Germany

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Journal of Cardiothoracic Surgery 2010, 5:25  doi:10.1186/1749-8090-5-25

Published: 18 April 2010

Abstract

Background

Despite the advantages of bilateral mammary coronary revascularization, many surgeons are still restricting this technique to the young patients. The objective of this study is to demonstrate the safety and potential advantages of bilateral mammary coronary revascularization in patients older than 65 years.

Methods

Group I included 415 patients older than 65 years with exclusively bilateral mammary revascularization. Using a propensity score we selected 389 patients (group II) in whom coronary bypass operations were performed using the left internal mammary artery and the great saphenous vein.

Results

The incidence of postoperative stroke was higher in group II (1.5% vs. 0%, P = 0.0111). The amount of postoperative blood loss was higher in group I (908 ± 757 ml vs. 800 ± 713 ml, P = 0.0405). There were no other postoperative differences between both groups.

Conclusion

Bilateral internal mammary artery revascularization can be safely performed in patients older than 65 years. T-graft configuration without aortic anastomosis is particularly beneficial in this age group since it avoids aortic manipulation, which is an important risk factor for postoperative stroke.