Purpose. Assessment of postoperative course and incidence of complications after CABG in elderly and senile patients.
Methods. 120 Russian elderly and senile CAD patients (60-86 y.o., middle age–72,7±10,4 y.o.) undergoing elective On-Pump CABG during 2018 year were enrolled into the trial. We analyzed postoperative course and the incidence of complications.
Results. There were some kinds of postoperative complications in 71,2% cases. Postpericardiotomy syndrome requiring glucocorticosteroids was diagnosed in 13.3% of cases. Postoperative arrhythmias were registered in 39.2% of patients, including new onset paroxysms of atrial fibrillation - in 30%, ventricular arrhythmias - in 9.2%, hemopericardium and re-exploration - in 3.3%, delayed healing of postoperative wounds with the application of secondary sutures - in 3.3%, active infection - in 10.8%, peripheral neuropathies - in 0.8% of patients. Atherosclerotic obstructive brachiocephalic artery lesions were not found according to duplex scanning. However, neurologic complications after CABG are noted in 5,8% patients: perioperative encephalopathy – in 1,7%, stroke verified with multislice spiral CT - in 3.3%, transient ischemic attack (TIA) – in 0,9%. Reduction of cognitive functions according to the MoCA was detected in 70% of patients. Dementia was not detected in any of the patients. The total duration of hospitalisation, associated with the surgery, was 24.8 ± 8.2 days; including 2,6 ± 2,3 days - in the intensive care unit, 5,2 ± 3,3 days - in the cardiosurgery department and 10,1 ± 5,9 days - in the rehabilitation department.
Conclusion. The incidence of postoperative arrhythmias, stroke in elderly and senile patients with CAD is slightly higher than similar data from modern trials performed on younger patients. It requires a detailed analysis with a careful neurological assessment of a larger number of patients. The received results can be used to improve the preparation and postoperative management of elderly and senile CAD patients and to plan the volume of postoperative neurorehabilitation.