Isolated Coronary Artery Bypass in Octogenarians: Does Gender Matter?

Abstract

BACKGROUND: Coronary artery bypass grafting (CABG) in octogenarians remains a challenging but increasingly common procedure due to extended life expectancy and the growing burden of coronary artery disease in the elderly. This study aimed to evaluate sex-specific differences in perioperative characteristics and early outcomes in patients aged ≥80 years undergoing isolated CABG. METHODS: A total of 104 patients aged ≥80 years who underwent isolated CABG between 2017 and 2023 were retrospectively analysed. Patients were stratified by gender, and comparisons were made regarding preoperative comorbidities, intraoperative variables, and postoperative outcomes. The primary endpoint was in-hospital mortality. RESULTS: The mean age was 82.01 ± 2.04 years, with 64.4% male and 35.6% female patients. While body surface area was significantly higher in males (p < 0.001), EuroSCORE II was numerically higher in females (p = 0.18). Chronic obstructive pulmonary disease (COPD) and smoking were more prevalent in males (p = 0.039 and p < 0.001, respectively), whereas CABG x5 was more frequent in females (p = 0.043). ICU stay was significantly longer in males (p = 0.014).Overall mortality was low (3.8%) and not significantly different between genders. CONCLUSIONS: CABG in patients aged ≥80 years is associated with low early mortality and acceptable complication rates regardless of gender. Preoperative and intraoperative gender based differences may inform individualised perioperative management strategies in this growing patient population.