Age and off-pump coronary artery bypass grafting: assessing surgical outcomes in elderly patients - a single-center perspective study

Abstract

Background: Coronary artery disease (CAD) remains a major global burden, increasingly affecting the elderly and requiring effective interventions like coronary artery bypass grafting (CABG). Off-pump CABG (OPCABG) has gained popularity as a technique that avoids cardiopulmonary bypass, reducing perioperative complications such as stroke and inflammatory responses. The impact of advanced age on OPCABG outcomes remains a critical area of investigation.

Methods: This comparative cross-sectional study was conducted in the Department of Cardiac Surgery at Bangladesh Medical University from January to December 2024, including 100 patients undergoing OPCABG, divided into two groups: patients younger than 65 years (n=50) and those older than 65 years (n=50).

Results: Data analysis revealed significant differences in post-operative outcomes, with elderly patients experiencing prolonged ventilation time (449.6±31.5 min versus 303.1±35.4 min, p<0.05), increased postoperative bleeding (450.6±81.3 ml versus 316.4±69.3 ml, p<0.05), and higher serum creatinine levels on the first postoperative day (1.9±0.2 mg/dl versus 1.5±0.3 mg/dl, p<0.05). Psychosis was more prevalent in the older cohort (4 versus 1 case, p=0.02), along with higher rates of wound infections after the fifth postoperative day (9 versus 2 cases, p=0.03) and respiratory tract infections in the ICU (8 versus 1 case, p=0.01).

Conclusions: Despite similar preoperative profiles, elderly patients faced more complications, highlighting the influence of age-related physiological changes on post-operative recovery. These findings highlight the need for optimized ventilation, strict infection control, and personalized postoperative care in elderly OPCABG patients.