Clinical Analysis Of Off-pump Coronary Artery Bypass Grafting In Patients Over 70 Years Old

Objective:To investigate the therapeutic effect of off-pump coronary artery bypass grafting(CABG)in patients over 70 years old,and summarize the relevant clinical experience.Methods:The clinical data of 173 patients with coronary atherosclerotic heart disease who underwent off-pump coronary artery bypass grafting in our hospital(second Hospital of Hebei Medical University)from January 2017 to January 2020 were retrospectively analyzed.Men accounted for 67.6% and women accounted for 32.4%,with an average age of(72.6 ± 2.44)years.There were 100 cases(57.8%)with previous smoking history,122 cases(70.5%)with hypertension history before surgery,54 cases(31.2%)with diabetes history,and 4 cases(2.3%)with cerebrovascular disease history.The number of bypasses,length of hospital stay,the incidence of important organ complications,and the incidence of recent cardiovascular adverse events.Results:Of the 173 patients,3 died and the others were cured and discharged.The average number of bypass grafts was(3.52 ±0.77),and the average hospital stay was(12.20 ±6.63)days.The perioperative mortality was 1.7%.The complications included malignant arrhythmia in 3 cases(1.7%),atrial fibrillation in 20 cases(11.6%),renal insufficiency in 39 cases(22.5%),cerebrovascular disease in 4 cases(2.3%),poor wound healing in 2 cases(1.2%),and so on.The patients were followed up for 3 months after discharge,and there was no myocardial ischemia event.Conclusion:There are many complications in elderly patients,and their condition is more serious.with adequate preoperative preparation,strict and meticulous evaluation and perioperative management,good results can still be achieved in elderly patients over 70 years old who undergo off-pump coronary artery bypass grafting.