초록접수 현황
| 14F-235 | 구연 발표 |
Early Outcomes of Saphenous Vein Composite Grafts for Coronary Artery Bypass; No-touch vs Minimally-manipulated Vein Grafts
김용한, 오홍철, 황호영, 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : Saphenous vein graft (SVG) patency in CABG could be influenced by the harvesting method. The purpose of this study was to evaluate the early outcomes of SVG harvested by the no-touch versus minimally manipulated techniques and used as a Y-composite graft anastomosed to the left internal thoracic artery in off-pump CABG patients.
Methods : Patients who were enrolled in the SAVE RITA trial between 2008 and 2011 used the SVG harvested minimally manipulated (MM group, n=109). Since October 2013, the SVG was harvested by no-touch technique (NT group, N=69). Early postoperative (1.4±1.1 days) angiography was performed in all patients and short-term clinical outcomes were compared.
Results : There was one operative mortality. No significant differences in postoperative morbidities, including atrial fibrillation and acute renal failure, were observed between the two groups. Early angiography showed 99.0%(383/387) overall patency rate in the MM group, and 100%(254/254) in the NT group (P=0.943). The patency rate of SVG in the MM and NT groups were 98.4%(248/252) and 100%(181/181), respectively (P=0.943). A Jackson-Pratt drain was inserted in the harvested saphenous vein bed in most patients (83 in MM, 68 in NT), showing that 5.1±3.6 days were required for removal in NT group, compared to 3.0±1.6 days in MM group (P=0.001).
Conclusion : The SVG harvested by the no-touch technique may improve patency by further preservation of endothelial integrity, vasa vasorum and surrounding tissue support of the vein although statistically insignificant in this study. We assume that the no-touch technique may also improve long-term patency rate.
Methods : Patients who were enrolled in the SAVE RITA trial between 2008 and 2011 used the SVG harvested minimally manipulated (MM group, n=109). Since October 2013, the SVG was harvested by no-touch technique (NT group, N=69). Early postoperative (1.4±1.1 days) angiography was performed in all patients and short-term clinical outcomes were compared.
Results : There was one operative mortality. No significant differences in postoperative morbidities, including atrial fibrillation and acute renal failure, were observed between the two groups. Early angiography showed 99.0%(383/387) overall patency rate in the MM group, and 100%(254/254) in the NT group (P=0.943). The patency rate of SVG in the MM and NT groups were 98.4%(248/252) and 100%(181/181), respectively (P=0.943). A Jackson-Pratt drain was inserted in the harvested saphenous vein bed in most patients (83 in MM, 68 in NT), showing that 5.1±3.6 days were required for removal in NT group, compared to 3.0±1.6 days in MM group (P=0.001).
Conclusion : The SVG harvested by the no-touch technique may improve patency by further preservation of endothelial integrity, vasa vasorum and surrounding tissue support of the vein although statistically insignificant in this study. We assume that the no-touch technique may also improve long-term patency rate.
책임저자: 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 김용한, Tel: 02-2072-2340 , E-mail : 01085198929@hanmail.net
