Study On The Curative Effect Of Off-pump Coronary Artery Bypass Surgery In Octogenarians

Objective To discuss the curative effect of off-pump coronary artery bypass grafting surgery in octogenarians.Methods A retrospective analysis of the preoperative age,gender,smoking,hypertension,diabetes,hyperlipidemia,BMI,preoperative oxygen pressure in elderly patients admitted to the Qingdao University Hospital from January 1,2014 to December30,2020 and preoperative lactic acid,preoperative creatinine,symptom onset time,symptom exacerbation time,preoperative cardiac ultrasonography,preoperative comorbidities and intraoperative operation time,number of bypasses,number of intramammary bridges,number of great saphenous vein bridges,Intraoperative IABP,intraoperative pacemaker,intraoperative bleeding,intraoperative plasma transfusion,intraoperative red blood cell transfusion,autotransfusion and postoperative oxygen partial pressure,postoperative lactic acid,postoperative creatinine,postoperative cardiotonic drug use time,Postoperative cardiotonic drugs,postoperative red blood cells,postoperative plasma,hospitalization days,ICU hospital stay,ventilator assistance time,postoperative cardiac ultrasonography,postoperative complications,death,abandonment of treatment and discharge,and follow-up 9 months-to 7 years survival status,cause of death,current situation and other data of the patient were sorted and analyzed.SPSS 26.0software was used for data analysis.Measurement data conformed to a normal distribution using x±S description,group comparison using t-test,non-normal distribution using M(P25,P75)description,component comparison using rank-sum test,count data using The frequency and percentage are described,the components are compared by chi-square test or Fisher’s exact test,and the difference is statistically significant with P<0.05.Results There were 34 patients in total,aged 80-90 years old,with an average age of 82(81,82.5)years old,including 20 males(58.8%),14 females(41.2%),and 3 deaths(8.8%)in the hospital after the operation.,2 cases(5.9%)of discharged patients who gave up treatment,1 case of acute cerebral infarction(2.9%),3 cases of tracheotomy(8.8%),and 2 cases of secondary intubation(5.9%)),CRRT was placed in 3 cases(8.8%),IABP was placed in 1 case(2.9%),pulmonary infection was in 9 cases(26.5%),pleural effusion was in 11 cases(32.4%),and the sternum was loosened in 1 case(2.9%),13cases(38.2%)asymptomatic patients after surgery,the average postoperative oxygen partial pressure 103(92.1,135)mm Hg,the average postoperative lactic acid 0.9(0.7,1.2)mmol/L,the average postoperative creatinine 93.7(83,129)umol/L,with an average postoperative EF of 60(56,64)%.The average postoperative cardiotonic drug use time was 3(2,8)days,the average postoperative cardiotonic drug types were 2(2,3),18 cases(52.9%)underwent postoperative red blood cell transfusion,and 27 cases(79.4%)underwent postoperative plasma transfusion,the average hospital stay is 28(20.5,31)days,the average ICU stay is 5(3,8)days,the average ventilator assist time is 1(1,2)d,patient follow-up 9 months-to 7 years,the average follow-up time was4.5(2.1,6)years,6 patients(20.7%)were disconnected,23 patients(79.3%)could be followed up,Among them,3 patients(13.0%)died from all causes.2 patients(8.7%)died of heart failure,and 20 patients(87.0%)were surviving.3 patients(13.0%)with heart function class III;heart function class IV 4 Cases(17.4%),1 case of atrial fibrillation(4.3%),2 cases(8.7%)of cerebral infarction,4 cases(17.4%)of chest tightness and breathlessness were admitted to the hospital,11 cases(47.8%)are currently in good health.Conclusion 1.The overall curative effect of off-pump coronary artery bypass grafting in patients aged 80 years and above is good,but there are many postoperative complications,among which pulmonary complications are the most significant.2.The long-term follow-up patients showed good overall mid-and long-term curative effects,and some of them had good quality of life.