초록접수 현황
| 16F-175 | 구연 발표 |
What is better Conduit for Revascularization of the Right Coronary Territory in Impaired LV Function? : Right Internal Thoracic Artery vs Saphenous Vein Graft
Suryeun Chung, Cheong Lim, Jun Sung Kim, Kay-Hyun Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea
Background : Coronary artery bypass surgery in patients with severe left ventricular dysfunction remains challenging to cardiac surgeon. Superiority of bilateral internal thoracic artery of left coronary system is well established with many clinical evidence. In contrast, the choice of graft the right coronary territory is still debatable. We aimed to analyze the clinical outcomes and revascularization rate of RCA territory revascularization using the RITA or SVG in left ventricular dysfunction.
Methods : A retrospective review was done for 178 patients who underwent coronary artery bypass surgery for left ventricular dysfunction(EF≤40%) from July 2003 through December 2015. For comparison of clinical outcomes and angiographic data of patency, the patients were divided into two groups according to the conduit; RITA (n=84) and SVG (n=94). Mean follow-up duration was 38.5 months (2day~160.5months). We evaluated graft patency using CT coronary angiography and coronary angiogram was performed if patients have angina pain or aggravating symptom. Sixty-five percent of patients (116/178) confirmed patent of graft during follow-up period.
Results : The proportion of emergency and preoperative IABP support was slightly higher in SVG group. Early mortality was 6.7% without any intergroup difference. (6.0% in RITA vs 7.4% in SVG p=0.77). Freedom from cardiac related death at 5-year were similar. (91.6±0.04 in RITA versus 88.8±0.04 in SVG group, p=0.45). Freedom from MACCE at 5-year also is not different both group. (87.2±0.05 in RITA versus 75.6± 0.06 in SVG, p=0.30)
In graft patency, SVG group showed more graft failure compared RITA group. (23.2% in SVG group vs 8.3% in RITA group, p=0.039) Freedom from graft failure at 5 year were slightly lower in SVG group (81.5±0.10 in RITA versus 67.6± 0.11, p=0.05).
Conclusion : In view of the graft patency, right internal thoracic artery is considered the first choice for right coronary revascularization at LV dysfunction compared SVG graft.
Methods : A retrospective review was done for 178 patients who underwent coronary artery bypass surgery for left ventricular dysfunction(EF≤40%) from July 2003 through December 2015. For comparison of clinical outcomes and angiographic data of patency, the patients were divided into two groups according to the conduit; RITA (n=84) and SVG (n=94). Mean follow-up duration was 38.5 months (2day~160.5months). We evaluated graft patency using CT coronary angiography and coronary angiogram was performed if patients have angina pain or aggravating symptom. Sixty-five percent of patients (116/178) confirmed patent of graft during follow-up period.
Results : The proportion of emergency and preoperative IABP support was slightly higher in SVG group. Early mortality was 6.7% without any intergroup difference. (6.0% in RITA vs 7.4% in SVG p=0.77). Freedom from cardiac related death at 5-year were similar. (91.6±0.04 in RITA versus 88.8±0.04 in SVG group, p=0.45). Freedom from MACCE at 5-year also is not different both group. (87.2±0.05 in RITA versus 75.6± 0.06 in SVG, p=0.30)
In graft patency, SVG group showed more graft failure compared RITA group. (23.2% in SVG group vs 8.3% in RITA group, p=0.039) Freedom from graft failure at 5 year were slightly lower in SVG group (81.5±0.10 in RITA versus 67.6± 0.11, p=0.05).
Conclusion : In view of the graft patency, right internal thoracic artery is considered the first choice for right coronary revascularization at LV dysfunction compared SVG graft.
책임저자: Cheong Lim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea
발표자: Suryeun Chung, E-mail : suryeun.chung@gmail.com