초록접수 현황
| 15F-082 | 구연 발표 |
Mid-term Results of Minimally Invasive Direct Coronary Artery Bypass Grafting
김준성, 박계현, 임청, 정수련, 김수현, 김정희, 김동중
서울대학교 의과대학 분당서울대학교병원 흉부외과학교실
Background : Minimally invasive direct coronary artery bypass grafting (MIDCAB) has an advantage of arterial grafting on left anterior descending artery (LAD) without sternotomy incision. Here, we present our single center clinical experience of 66 consecutive patients.
Methods : All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007, and July 2015. Preoperative, intraoperative, postoperative, and follow-up data including major adverse cerebrovascular events (MACCE), graft patency, and need for re-intervention were collected.
Results : Mean age was 69.4±11.1 years and 72.5% were male. There was no conversion to on-pump or sternotomy incision. Thirty-day mortality was 1.5%. There was no stroke and two patients (3.0%) had to be re-explored for bleeding. 81.8% were extubated in the operating room or on the day of surgery. Median stay at the intensive care unit and in hospital were 1 (1 to 22) and 7 (4 to 57) days, respectively. 33.3% received no transfusion. Median follow-up period was 11 months (0 to 90) and complete in 100% with 5-year overall survival of 72.8±9.7% and 5-year MACCE-free survival of 85.3±9.1%. 32 of 66 patients underwent postoperative graft patency study with CT angiography or coronary angiography ; 88.9% (32 of 36 grafts) were patent at postoperative 9.7±10.8 months. One patients had a re-intervention on target vessel and three patients non-target vessel during follow up period.
Conclusion : MIDCAB is safe procedure with low postoperative morbidity, mortality , and favorable mid-term MACCE-free survival in selected patients. Heart team approach for single vessel disease is mandatory for better management.
Methods : All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007, and July 2015. Preoperative, intraoperative, postoperative, and follow-up data including major adverse cerebrovascular events (MACCE), graft patency, and need for re-intervention were collected.
Results : Mean age was 69.4±11.1 years and 72.5% were male. There was no conversion to on-pump or sternotomy incision. Thirty-day mortality was 1.5%. There was no stroke and two patients (3.0%) had to be re-explored for bleeding. 81.8% were extubated in the operating room or on the day of surgery. Median stay at the intensive care unit and in hospital were 1 (1 to 22) and 7 (4 to 57) days, respectively. 33.3% received no transfusion. Median follow-up period was 11 months (0 to 90) and complete in 100% with 5-year overall survival of 72.8±9.7% and 5-year MACCE-free survival of 85.3±9.1%. 32 of 66 patients underwent postoperative graft patency study with CT angiography or coronary angiography ; 88.9% (32 of 36 grafts) were patent at postoperative 9.7±10.8 months. One patients had a re-intervention on target vessel and three patients non-target vessel during follow up period.
Conclusion : MIDCAB is safe procedure with low postoperative morbidity, mortality , and favorable mid-term MACCE-free survival in selected patients. Heart team approach for single vessel disease is mandatory for better management.
책임저자: 김준성
서울대학교 의과대학 분당서울대학교병원 흉부외과학교실
연락처 : 김준성, Tel: 927 , E-mail : junekim73@gmail.com
