Impact Of Aorta No-touch Mics Cabg For Older Patients
Takakimi Mizuno, Kazutoshi Tachibana, Masato Yonemori.
Hakodate Goryoukaku Hospital, Hakodate, Japan.
BACKGROUND: Coronary Artery Bypass Grafting (CABG) plays an important role in the treatment of coronary artery diseases. However Older patients with coronary artery diseases are at increased risk for perioperative complications and long hospital stays that affect postoperative ADL. Aorta no-touch total arterial Minimally Invasive Cardiac Surgery CABG (MICS CABG) may mitigate these problems. We compared the perioperative outcomes of patients underwent aorta no-touch total arterial MICS CABG with that of sternotomy CABG by age-group. METHODS: The consecutive 100 patients underwent Isolated CABG excluded acute coronary syndrome, 29 patients underwent aorta no-touch total arterial MICS CABG (Group M) and 71 patients underwent sternotomy CABG (Group S) were reviewed. We divided them into three groups according to age: young age (< 65 years old), middle age (65-74years old) and older age (> 75years old). We assessed perioperative outcomes by age-groups as well. RESULTS: The proportion of each age-group (young age: middle age: older age) was 8 (27.5%) : 9 (31.0%) : 12 (41.4%) in MICS CABG, 21(29.5%) , 32 (45.1%) , 18 (25.4%) in sternotomy CABG . The population of older age patients tended to be more increasing in group M than in group S. In both older age groups, the graft patency rate was 100% and the early death rate was 0 (0%). The average hospital stays of the two groups in each age-group was 8.4 days: 9.3 days: 16.2days in MICS CABG (< 0.05) and 17.3days: 15.6days: 20.5days(p=0.06). Comparing perioperative complications, in middle and older age of group M (> 65years old), there were 0 cases of cerebral infarction, 0 cases of mediastinitis, 0 cases of wound infection. On the other hand, in middle and older age of group S (> 65years old), there were 0 cases of cerebral infarction, 0 cases of mediastinitis, 4 cases of wound infection. In MICS CABG (> 65years old), the average hospital stays was 13±7.3 days, which was significantly better than 17±6.9 days in sternotomy CABG (< 0.05).CONCLUSIONS: Aorta No-touch Total Arterial MICS CABG may mitigate the complications compared with Full sternotomy CABG and could improve surgical advantage due to fast ADL recovery. 
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