초록접수 현황
| 15F-245 | 포럼 발표 |
Off-pump Coronary Artery Bypass in Patients with Left Ventricular Dysfunction
이재홍, 김용한, 오홍철, 최재웅, 황호영, 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : We evaluated the surgical results after off-pump coronary artery bypass (OPCAB) in patients with left ventricular (LV) dysfunction.
Methods : Of 2521 patients who underwent OPCAB between January 1998 and December 2014, 256 patients who had LV dysfunction (LV ejection fraction, LVEF≤35%)(group D) and 1846 patients who had normal LV function (LVEF≥50%)(group N) were studied. Patients who had mild LV dysfunction (35%
Results : Overall early mortality (<30 days) was 1.0% (21/2102; groups D vs N, 2.0%, 5/256 vs 0.9%, 16/1846; p=0.167). Postoperative morbidities included atrial fibrillation (n=543, 25.3%; 30.1% vs 25.3%; p=0.100), acute kidney injury (n=83, 4.0%; 6.3% vs 3.6%, p=0.041), reoperation for bleeding (n=53, 2.5%; 2.4% vs 2.5%, p=0.859), respiratory complications (n=38, 1.8%; 4.3% vs 1.5%, p=0.004), low cardiac output syndrome (n=10, 0.5%; 1.6% vs 0.3%; p=0.024), and mediastinitis (n=12, 0.6%; 1.2% vs 0.5%; p=0.169). The time to extubation, intensive care unit stay, and the time to discharge were significantly longer in groups D vs N (38.4±77.9 hours vs 24.8±58.7 hours, p=0.008; 54.9±97.4 hours vs 36.6±67.5 hours, p=0.004; 14.3±24.2 days vs 9.9±16.7 days, p=0.006). Left main disease with 3-vessel disease with (p=0.005) was the only significant risk factor for early mortality, and urgent surgery was a risk factor for early mortality with marginal significance (p=0.064). Left ventricular dysfunction was not a risk factor for early mortality.
Conclusion : Although patients with LV dysfunction showed increased morbidities and prolonged ventilator support, intensive care unit stay and hospital stay, no significant difference in early mortality was found when compared with those with normal LV function. LV dysfunction itself was not a risk factor for early mortality in patients who underwent OPCAB.
Methods : Of 2521 patients who underwent OPCAB between January 1998 and December 2014, 256 patients who had LV dysfunction (LV ejection fraction, LVEF≤35%)(group D) and 1846 patients who had normal LV function (LVEF≥50%)(group N) were studied. Patients who had mild LV dysfunction (35%
Results : Overall early mortality (<30 days) was 1.0% (21/2102; groups D vs N, 2.0%, 5/256 vs 0.9%, 16/1846; p=0.167). Postoperative morbidities included atrial fibrillation (n=543, 25.3%; 30.1% vs 25.3%; p=0.100), acute kidney injury (n=83, 4.0%; 6.3% vs 3.6%, p=0.041), reoperation for bleeding (n=53, 2.5%; 2.4% vs 2.5%, p=0.859), respiratory complications (n=38, 1.8%; 4.3% vs 1.5%, p=0.004), low cardiac output syndrome (n=10, 0.5%; 1.6% vs 0.3%; p=0.024), and mediastinitis (n=12, 0.6%; 1.2% vs 0.5%; p=0.169). The time to extubation, intensive care unit stay, and the time to discharge were significantly longer in groups D vs N (38.4±77.9 hours vs 24.8±58.7 hours, p=0.008; 54.9±97.4 hours vs 36.6±67.5 hours, p=0.004; 14.3±24.2 days vs 9.9±16.7 days, p=0.006). Left main disease with 3-vessel disease with (p=0.005) was the only significant risk factor for early mortality, and urgent surgery was a risk factor for early mortality with marginal significance (p=0.064). Left ventricular dysfunction was not a risk factor for early mortality.
Conclusion : Although patients with LV dysfunction showed increased morbidities and prolonged ventilator support, intensive care unit stay and hospital stay, no significant difference in early mortality was found when compared with those with normal LV function. LV dysfunction itself was not a risk factor for early mortality in patients who underwent OPCAB.
책임저자: 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 이재홍, Tel: 02-2072-3898 , E-mail : holyjh85@naver.com
