초록접수 현황
| 14F-177 | 포럼 발표 |
Mid-term Results of On-pump Beating Heart Coronary Artery Bypass Grafting
Ho Jin Kim, MD; Suk Jung Choo, MD, PhD; Jae Suk Yoo, MD, PhD; Joon Bum Kim, MD, PhD; Sung-Ho Jung, MD, PhD; Cheol Hyun Chung, MD, PhD; Jae Won Lee, MD, PhD
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
Background : Inferior long term survival outcomes have been suggested with off-pump coronary artery bypass grafting (OPCAB) compared to conventional coronary bypass grafting (cCABG). In this study, on-pump beating heart CABG as a means of obviating cardioplegic arrest while retaining the advantages of OPCAB is investigated.
Methods : A total of 637 patients (mean age, 63.2±9.0 years; 171 females) consecutively undergoing CABG with cardiopulmonary bypass (on-pump beating, n=164; conventional CABG, n=473) from January 2006 to August 2011 were assessed. The outcomes were assessed using propensity scores and inverse-probability-weighting to reduce the impact of selection bias.
Results : The overall 30-day mortality rate was 0.01% (on-pump beating: n=1; conventional CABG: n=7). The distal anastomosis number was similar (on-pump beating vs. conventional CABG, 2.9 ± 0.8 vs. 3.0 ± 0.9; P=0.09). During a median follow-up of 74.2 months (Quartile 1-3, 61.7-87.9 months), 71 patients (11.1%) died. After adjustment, on-pump beating CABG patients tended to have lower early mortality risks compared to conventional CABG patients; relative risks of 30-day, 60-day and 90-day mortality of 0.22 (95% confidence interval [CI], 0.01-5.34; P=0.35), 0.11 (95% CI, 0.01-2.60; P=0.17) and 0.10 (95% CI, 0.01-2.35; P=0.16), respectively. However, the overall mortality risk was similar in both groups (hazard ratio [HR], 1.21; 95% CI, 0.64-2.27; P=0.57).
Conclusion : On pump beating heart CABG tended show a lower risk of early mortality compared to cCABG. The results suggest that on-pump beating heart CABG may be a reasonable alternative to conventional CABG for high risk cardioplegic arrest patients while retaining most of the advantages of OPCAB.
Methods : A total of 637 patients (mean age, 63.2±9.0 years; 171 females) consecutively undergoing CABG with cardiopulmonary bypass (on-pump beating, n=164; conventional CABG, n=473) from January 2006 to August 2011 were assessed. The outcomes were assessed using propensity scores and inverse-probability-weighting to reduce the impact of selection bias.
Results : The overall 30-day mortality rate was 0.01% (on-pump beating: n=1; conventional CABG: n=7). The distal anastomosis number was similar (on-pump beating vs. conventional CABG, 2.9 ± 0.8 vs. 3.0 ± 0.9; P=0.09). During a median follow-up of 74.2 months (Quartile 1-3, 61.7-87.9 months), 71 patients (11.1%) died. After adjustment, on-pump beating CABG patients tended to have lower early mortality risks compared to conventional CABG patients; relative risks of 30-day, 60-day and 90-day mortality of 0.22 (95% confidence interval [CI], 0.01-5.34; P=0.35), 0.11 (95% CI, 0.01-2.60; P=0.17) and 0.10 (95% CI, 0.01-2.35; P=0.16), respectively. However, the overall mortality risk was similar in both groups (hazard ratio [HR], 1.21; 95% CI, 0.64-2.27; P=0.57).
Conclusion : On pump beating heart CABG tended show a lower risk of early mortality compared to cCABG. The results suggest that on-pump beating heart CABG may be a reasonable alternative to conventional CABG for high risk cardioplegic arrest patients while retaining most of the advantages of OPCAB.
책임저자: 주석중
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
연락처 : 김호진, Tel: 02-542-3224 , E-mail : rhonin.hojin@gmail.com
