HOW WORTHY CORONARY ARTERY BYPASS-GRAFT SURGERY IN OLD PATIENTS IS? TWENTY YEARS SINGLE CENTER EXPERIENCE.

Background: Cardiac surgery in elderly patients is constantly growing, due to increase in life expectancy and quality of life. We retrospectively analyzed results of surgical revascularization in patients in their eighties. Methods: From January 2002 to December 2022, 3085 patients undergoing coronary artery bypass-graft were enrolled. Patients were divided in group I (age over 80) with 314 patients and group II (age under 80) 2462 patients. Results: In group I there were more female patients, less history of smoking, dialysis, acute myocardial infarction and percutaneous coronary interventions. Euroscore II was higher in group I and left main was more frequently involved. Group I showed a higher prevalence of revascularization with only great saphenous vein and off pump revascularization. In-hospital stay did not differ between the two groups (10.7± 7.1 vs 10.6 ± 6.6, p 0.8) even if neurological complications, prolonged mechanical ventilation (>48 h) and acute renal failure occurred more frequently in Group I. Inhospital mortality in group I was 4.1% vs 1.5% mostly related to complications rather than cardiac causes. Conclusions: Patients over eighty undergoing surgical revascularization show higher Euroscore, mainly due to the age but less comorbidities, reflecting strictly patient selection. Inhospital mortality is lower than 5%, slightly higher than younger patients. Most of deaths occurred due to non- cardiac complications which suggest the importance of preoperativepatient selection, exclusion of other therapeutic options and the relevance of postoperative care. Therefore, surgical revascularization remains a worthy option in selected elderly patients with good results.