초록접수 현황
| 16F-202 | 구연 발표 |
The Early Clinical Benefits of Anaortic Off-pump CABG Compared to Aortic Manipulated Off-pump CABG
Jae Woong Choi, Sang Yoon Yeom, Sue Hyun Kim, Ki-Bong Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Background : Off-pump coronary artery bypass grafting (off-pump CABG, OPCAB) with aortic manipulation could make worse neurologic outcomes compared to anaortic OPCAB. We compared the early clinical outcomes of anaortic OPCAB (non-AM group) with those of aortic manipulated OPCAB (AM group).
Methods : Of 2598 patients who underwent isolated CABG between January 2000 and December 2015 (2516 OPCAB and 82 On-pump CABG), we studied 2,243 patients underwent primary isolated OPCAB in elective or urgent situation. Forty nine patients were manipulated aorta during OPCAB and the others (n = 2194) underwent anaortic OPCAB. The type of aortic manipulation were partial clamp (n = 17), usage of heartstring device (n = 25), IABP insertion through ascending aorta (n = 7), and prophylactic cannulation (n=1).
Results : Operative mortality occurred in 24 patients (1.1%) and there were no significant differences in early mortality. Length of hospital stay was longer in AM group with marginal significance (p = 0.075). The postoperative stroke occurred in 26 (1.2%) patients and the incidence was significant higher in AM group (non-AM group: 1.1%, AM group: 6.1%, p = 0.018). The other postoperative morbidities showed no significant differences between groups. Age, postoperative atrial fibrillation, history of stroke and aortic manipulation were significant risk factors for postoperative stroke in univariate analyses. In multivariate analysis, history of stroke and aortic manipulation were significant risk factors for postoperative stroke.
Conclusion : Aortic manipulation during OPCAB was associated with occurrence of postoperative stroke. Anaortic OPCAB showed good early clinical outcomes compared to OPCAB with aortic manipulation regarding hospital stay and postoperative stroke.
Methods : Of 2598 patients who underwent isolated CABG between January 2000 and December 2015 (2516 OPCAB and 82 On-pump CABG), we studied 2,243 patients underwent primary isolated OPCAB in elective or urgent situation. Forty nine patients were manipulated aorta during OPCAB and the others (n = 2194) underwent anaortic OPCAB. The type of aortic manipulation were partial clamp (n = 17), usage of heartstring device (n = 25), IABP insertion through ascending aorta (n = 7), and prophylactic cannulation (n=1).
Results : Operative mortality occurred in 24 patients (1.1%) and there were no significant differences in early mortality. Length of hospital stay was longer in AM group with marginal significance (p = 0.075). The postoperative stroke occurred in 26 (1.2%) patients and the incidence was significant higher in AM group (non-AM group: 1.1%, AM group: 6.1%, p = 0.018). The other postoperative morbidities showed no significant differences between groups. Age, postoperative atrial fibrillation, history of stroke and aortic manipulation were significant risk factors for postoperative stroke in univariate analyses. In multivariate analysis, history of stroke and aortic manipulation were significant risk factors for postoperative stroke.
Conclusion : Aortic manipulation during OPCAB was associated with occurrence of postoperative stroke. Anaortic OPCAB showed good early clinical outcomes compared to OPCAB with aortic manipulation regarding hospital stay and postoperative stroke.
책임저자: Ki-Bong Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
발표자: Jae Woong Choi, E-mail : woong3537@hanmail.net