초록접수 현황
| 14F-255 | 구연 발표 |
Fate of Mild to Moderate Mitral Regurgitation (MR) after Isolated Off-pump Coronary Artery Bypass Grafting (OPCAB)
이형채, 윤영남, 이승현, 주현철, 이삭, 유경종
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Background : The aim of this study was to compare pre- and post-operative echocardiogram after isolated OPCAB in patients with mild to moderate MR, and examine late clinical outcomes.
Methods : Of 1358 consecutive patients undergoing isolated OPCAB between January, 2008 and December, 2013, 193 were MR grade III (n=6, 3.0%), II (n=56, 28.9%), I (n=131, 67.5%) on the pre-operative echocardiogram. We evaluate post-operative echocardiographic variables (EF, LVEDD, LVESD, LV mass index, RWT, mean wall motion score) and follow up MACCEs.
EF : ejection fraction, LVEDD : left ventricular end-diastolic dimension, LVESD : left ventricular end-systolic dimension, RWT : relative wall thickness
Results : Mean age was 67.2±8.4 years, and 59 (31%) were female. Mean echocardiogram follow up was 15±19 month (range 0 to 75). MR grade decreased from 1.4±0.5 to 0.5±0.7. 133 (69%) of patients improved, whereas 6 (3.0%) worsen in terms of MR. Follow up residual MR II or III were present in 14 (7.3%) patients. LVEF (%, 44±14 to 48±13, p<0.01), LVEDD (mm, 56.0±7.7 to 52.6±7.7, p<0.01), and LVESD (mm, 43.3±10.0 to 39.4 ±10.0, p<0.01) changed significantly after OPCAB. LV mass index (g/m2,122.9±30 to 115±30.6, p<0.01) and RWT (cm , 0.34±0.1 to 0.36±0.1 , p<0.01)were also improved. Mean wall motion score changed from 1.8±0.5 to 1.6±0.5 (p<0.01). Territories of wall motion abnormality did not affect improving of MR.
Conclusion : 69% of mild MR improved after isolated OPCAB. Late follow up echocardiogram reveal that positive reverse remodeling was achieved after isolated OPCAB in patients with mild MR.
Methods : Of 1358 consecutive patients undergoing isolated OPCAB between January, 2008 and December, 2013, 193 were MR grade III (n=6, 3.0%), II (n=56, 28.9%), I (n=131, 67.5%) on the pre-operative echocardiogram. We evaluate post-operative echocardiographic variables (EF, LVEDD, LVESD, LV mass index, RWT, mean wall motion score) and follow up MACCEs.
EF : ejection fraction, LVEDD : left ventricular end-diastolic dimension, LVESD : left ventricular end-systolic dimension, RWT : relative wall thickness
Results : Mean age was 67.2±8.4 years, and 59 (31%) were female. Mean echocardiogram follow up was 15±19 month (range 0 to 75). MR grade decreased from 1.4±0.5 to 0.5±0.7. 133 (69%) of patients improved, whereas 6 (3.0%) worsen in terms of MR. Follow up residual MR II or III were present in 14 (7.3%) patients. LVEF (%, 44±14 to 48±13, p<0.01), LVEDD (mm, 56.0±7.7 to 52.6±7.7, p<0.01), and LVESD (mm, 43.3±10.0 to 39.4 ±10.0, p<0.01) changed significantly after OPCAB. LV mass index (g/m2,122.9±30 to 115±30.6, p<0.01) and RWT (cm , 0.34±0.1 to 0.36±0.1 , p<0.01)were also improved. Mean wall motion score changed from 1.8±0.5 to 1.6±0.5 (p<0.01). Territories of wall motion abnormality did not affect improving of MR.
Conclusion : 69% of mild MR improved after isolated OPCAB. Late follow up echocardiogram reveal that positive reverse remodeling was achieved after isolated OPCAB in patients with mild MR.
책임저자: 유경종
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
연락처 : 이형채, Tel: 02-2228-8489 , E-mail : cvsdoc@yuhs.ac
