초록접수 현황
| 15F-147 | 포럼 발표 |
CABG First Or PCI First : Which is Better in Two-staged Hybrid Coronary Revascularization?
최항준, 강준규, 김도연, 송현
가톨릭대학교 의과대학 서울성모병원 흉부외과학교실
Background : Hybrid approach to coronary revascularization (HCR) was introduced at mid-1990s and aspired to bring together the advantages of LIMA-LAD surgical bypass with minimal invasiveness of PCI. Several controlled studies have proven safety, feasibility, and efficacy of HCR. However, it is still controversial about optimal order; PCI first versus CABG first. The purpose of this study is to compare the outcomes of these two approaches.
Methods : Sixty three patients who underwent HCR from May, 2010 to December, 2012 were enrolled to retrospective analysis. CABG first group (CABGF) comprised 10 patients and PCI first group (PCIF) included 53 patients. The outcome variables that were compared between groups were reoperation, hospital stay, major cardiac adverse events, repeated target vessel revascularization, and early and late mortality. Primary end-point was postoperative mortality and secondary end-point was repeated target vessel revascularization.
Results : The mean age of the patients was 66 years (46 - 85). Demographic and basal characteristics of the patients in both groups were not significantly different. There was one reoperation in each two groups due to postoperative bleeding (p=0.29). Hospital stay between two groups was not significantly different (p=0.29). There was no early postoperative mortality in both groups. No major cardiac adverse event before discharge was reported in both groups. Repeated target vessel revascularization was performed at 6 patients in PCIF group only, but there was no statically difference (p=0.58). One patient in PCIF group died with sudden cardiac arrest 6 month after operation.
Conclusion : There was no significant difference in outcomes between CABG first and PCI first group. Based on our results, we would suggest either CABG or PCI can be safely opted as a primary procedure in 2-stage hybrid coronary revascularization. Further investigation with a randomized control study will be necessary to guide a proper decision making.
Methods : Sixty three patients who underwent HCR from May, 2010 to December, 2012 were enrolled to retrospective analysis. CABG first group (CABGF) comprised 10 patients and PCI first group (PCIF) included 53 patients. The outcome variables that were compared between groups were reoperation, hospital stay, major cardiac adverse events, repeated target vessel revascularization, and early and late mortality. Primary end-point was postoperative mortality and secondary end-point was repeated target vessel revascularization.
Results : The mean age of the patients was 66 years (46 - 85). Demographic and basal characteristics of the patients in both groups were not significantly different. There was one reoperation in each two groups due to postoperative bleeding (p=0.29). Hospital stay between two groups was not significantly different (p=0.29). There was no early postoperative mortality in both groups. No major cardiac adverse event before discharge was reported in both groups. Repeated target vessel revascularization was performed at 6 patients in PCIF group only, but there was no statically difference (p=0.58). One patient in PCIF group died with sudden cardiac arrest 6 month after operation.
Conclusion : There was no significant difference in outcomes between CABG first and PCI first group. Based on our results, we would suggest either CABG or PCI can be safely opted as a primary procedure in 2-stage hybrid coronary revascularization. Further investigation with a randomized control study will be necessary to guide a proper decision making.
책임저자: 강준규
가톨릭대학교 의과대학 서울성모병원 흉부외과학교실
연락처 : 최항준, Tel: 02-594-0174 , E-mail : chjbeatles@naver.com
