How does age influence CABG risk and graft selection?

• A. Younger age increases risk
• B. Age has no effect on CABG risk
• C. Older age increases overall risk and recovery complexity, but arterial grafts may still offer durable patency; decisions depend on comorbidity and functional status
• D. Grafts should be venous only in older age

Answer: (C)

Age affects risk in CABG because older patients typically have more comorbidities and reduced physiologic reserve, which raises perioperative mortality, complications (like kidney injury or stroke), and the complexity of recovery and rehab. Graft selection reflects this balance: arterial grafts, such as internal thoracic arteries or the radial artery, tend to stay patent longer than vein grafts and offer superior long-term durability. However, using arterial conduits can be more technically demanding and may carry higher immediate risks in some patients, especially those with calcified vessels or higher risk for sternal complications. Therefore, even though arterial grafts may still provide durable patency, the choice is personalized, based on the patient’s comorbidity burden, functional status, life expectancy, and coronary anatomy.