초록접수 현황
| 14F-257 | 구연 발표 |
Case Series of OPCAB in Octagenerian Patients Who Having Inevitable Major Non-cardiac Surgical Conditions
김두상, 문정하, 박형호, 이민혁, 윤동주, 김정문
중앙보훈병원 흉부외과
Background : Usually octagenerians are accepted as a contraindication to major operation including CABG. However, the needs for operations are increasing nowadays at both patient and his family’s request. Here we report early experience of OPCAB in octagenerian patients who having a disease condition which needs major non-cardiac surgery.
Methods : From December 2013 to August 2014, 14 cases were enrolled as the subjects of study, who had underwent OPCAB and non-cardiac surgery, as staged (n=1, interval 16 days) or simultaneous (n=13) manner. Median age is 83 years old (range 80 to 91) and concomitant diseases are PAOD (n=8), lung cancer (n=3), aortic obstruction (n=1), AAA (n=1), and esophageal cancer (n=1). We conducted OPCAB as minimally invasive (n=11) or full-sternotomy (n=3) manner, and major non-cardiac surgery procedures as follows: F-P bypass (n=7), aorto-femoral bypass (n=2), Ivor Lewis procedure (n=1), bi-lobectomy (n=1), lobectomy with bronchoplasty (n=1), wedge resection (n=1) and EVAR (n=1).
Results : Median op time is 305 min (range 165 to 535), and there was no on-pump conversion. Postop ICU-stay and hospital-stay are 3 days (range 1 to 11) and 25 days (range 13 to 52), respectively. There were 5 morbidities (36%) including pneumonia (n=3), inguinal pseudoaneurysm (n=1) and ARF (needs CRRT, n=1). There was one operative mortality patient (7%) who had underwent MICS OPCAB with bi-lobectomy and expired due to pneumonia at postoperative 29 days. Mean follow-up is 163 days (95% C.I. 117 to 209) and there were two follow-up mortality patients who had underwent MICS OPCAB with F-P bypasses. They expired at postoperative 52 and 89 days due to delayed pneumonia and delayed ulcer bleeding, respectively.
Conclusion : We report early experience of OPCAB in octagenerian patients who having a disease condition which needs major non-cardiac surgery.
Methods : From December 2013 to August 2014, 14 cases were enrolled as the subjects of study, who had underwent OPCAB and non-cardiac surgery, as staged (n=1, interval 16 days) or simultaneous (n=13) manner. Median age is 83 years old (range 80 to 91) and concomitant diseases are PAOD (n=8), lung cancer (n=3), aortic obstruction (n=1), AAA (n=1), and esophageal cancer (n=1). We conducted OPCAB as minimally invasive (n=11) or full-sternotomy (n=3) manner, and major non-cardiac surgery procedures as follows: F-P bypass (n=7), aorto-femoral bypass (n=2), Ivor Lewis procedure (n=1), bi-lobectomy (n=1), lobectomy with bronchoplasty (n=1), wedge resection (n=1) and EVAR (n=1).
Results : Median op time is 305 min (range 165 to 535), and there was no on-pump conversion. Postop ICU-stay and hospital-stay are 3 days (range 1 to 11) and 25 days (range 13 to 52), respectively. There were 5 morbidities (36%) including pneumonia (n=3), inguinal pseudoaneurysm (n=1) and ARF (needs CRRT, n=1). There was one operative mortality patient (7%) who had underwent MICS OPCAB with bi-lobectomy and expired due to pneumonia at postoperative 29 days. Mean follow-up is 163 days (95% C.I. 117 to 209) and there were two follow-up mortality patients who had underwent MICS OPCAB with F-P bypasses. They expired at postoperative 52 and 89 days due to delayed pneumonia and delayed ulcer bleeding, respectively.
Conclusion : We report early experience of OPCAB in octagenerian patients who having a disease condition which needs major non-cardiac surgery.
책임저자: 김두상
중앙보훈병원 흉부외과
연락처 : 김두상, Tel: 02-2225-1347 , E-mail : doosang1@nate.com
