초록접수 현황
| 15F-229 | 구연 발표 |
The Efficacy of Heartstring Device and Postoperative Neurologic Complications According to Aortic Atherosclerosis Grades in Off-pump Coronary Artery Bypass
Do Jung Kim, Seung Hyun Lee, Hyun-Chel Choo, Sak Lee, Byung-Chul Chang, Kyung-Jong Yoo, Young-Nam Youn
Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Background : Severe aortic atherosclerosis is one of the risk factors for stroke during coronary artery bypass graft. The purpose of this study is to compare the incidence of postoperative neurologic complications after off-pump coronary artery bypass (OPCAB) between the Heartstring-used group and Aorta no-touch group
Methods : From January 2011 to December 2014, total 785 patients underwent OPCAB. The cohort was divided into 2 groups according to the use of Heartstring (group 1: Heartstring, group 2: no-touch Aorta). Atherosclerosis grade (Katz grade: I-V) of aorta by intraoperative epiaortic ultrasonography were evaluated in all patients. End points were postoperative neurologic complications (major: stroke proven by imaging study and clear symptoms, minor: delirium, transient ischemic attack (TIA), syncope, seizure), late major adverse cardiac events (MACEs) and mortality.
Results : Results: Group 1 was 343 (43.7%), and group 2 was 442 (56.3%). Mean age was 64.8 ± 9.49 years in group1 and 65.6 ± 9.47 years in group 2 (p=0.5) and incidences of other preoperative risk factors were similar. 6 (0.8%) of the patients were grade I, 115 (14.6%) grade II, 290 (36.9%) grade III, 327 (41.7%) grade IV and 47(6%) grade V according to Katz classification. Incidence of major neurologic complication was 1.2% (n=4) in group 1 and 1.1% (n=5) in group 2 (p=1.00). However, minor neurologic complications (14.6% vs. 7.5%, p=0.01) and overall neurologic complications (15.2% vs. 8.4%, p=0.01) occurred more in group 1, significantly. Incidences of major neurologic complications according to Katz grade were as followings: 1) grade III (n=2, 0.7%), grade IV (n=1, 0.3%) and grade V (n=1, 2.1%) in group1, 2) grade II (n=2, 1.7%), grade III (n=2, 0.7%) and grade V (1, 2.1%) in group2 (group 1 vs. group 2, p=1.0). In-hospital mortality was similar between groups (3[0.9%] vs. 5[1.1%], p=1.00) and the overall survival rates at 1 and 3 years were 97.9%, 95.1% in group 1 and 96.8%, 95.4% in group 2 (p=0.83).
Conclusion : There is no difference in the incidence of major stoke between two groups. However, minor neurologic complications occurred more in the Heartstring group. Therefore, Heartstring might be used safely in OPCAB regardless aortic arthrosclerosis grade.
Methods : From January 2011 to December 2014, total 785 patients underwent OPCAB. The cohort was divided into 2 groups according to the use of Heartstring (group 1: Heartstring, group 2: no-touch Aorta). Atherosclerosis grade (Katz grade: I-V) of aorta by intraoperative epiaortic ultrasonography were evaluated in all patients. End points were postoperative neurologic complications (major: stroke proven by imaging study and clear symptoms, minor: delirium, transient ischemic attack (TIA), syncope, seizure), late major adverse cardiac events (MACEs) and mortality.
Results : Results: Group 1 was 343 (43.7%), and group 2 was 442 (56.3%). Mean age was 64.8 ± 9.49 years in group1 and 65.6 ± 9.47 years in group 2 (p=0.5) and incidences of other preoperative risk factors were similar. 6 (0.8%) of the patients were grade I, 115 (14.6%) grade II, 290 (36.9%) grade III, 327 (41.7%) grade IV and 47(6%) grade V according to Katz classification. Incidence of major neurologic complication was 1.2% (n=4) in group 1 and 1.1% (n=5) in group 2 (p=1.00). However, minor neurologic complications (14.6% vs. 7.5%, p=0.01) and overall neurologic complications (15.2% vs. 8.4%, p=0.01) occurred more in group 1, significantly. Incidences of major neurologic complications according to Katz grade were as followings: 1) grade III (n=2, 0.7%), grade IV (n=1, 0.3%) and grade V (n=1, 2.1%) in group1, 2) grade II (n=2, 1.7%), grade III (n=2, 0.7%) and grade V (1, 2.1%) in group2 (group 1 vs. group 2, p=1.0). In-hospital mortality was similar between groups (3[0.9%] vs. 5[1.1%], p=1.00) and the overall survival rates at 1 and 3 years were 97.9%, 95.1% in group 1 and 96.8%, 95.4% in group 2 (p=0.83).
Conclusion : There is no difference in the incidence of major stoke between two groups. However, minor neurologic complications occurred more in the Heartstring group. Therefore, Heartstring might be used safely in OPCAB regardless aortic arthrosclerosis grade.
책임저자: Young-Nam Youn
Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
연락처 : Do Jung Kim, Tel: 010-6295-2102 , E-mail : phalcorpse@yuhs.ac
