초록접수 현황
| 16F-248 | 구연 발표 |
Extra-anatomic Abdomen-sparing Ascending Aorto-femoral Artery Bypass Surgery Showed Good Patency in the Patients Who had Mid-aortic Disease
Doosang Kim, Jungeun Kim, Hyungho Park, Taekyu Kim, Dongju Yun, Jungmoon Kim
Department of Thoracic and Cardiovascular Surgery, Veterans Health Service Medical Center, Seoul, Korea
Background : Mid-aortic disease or mid-aortic syndrome, which is characterized by juxta-renal aortic obstruction, is a rare and challenging condition for aortic surgeons to repair. We report the results of extra-anatomic abdomen-sparing ascending aorto-femoral artery bypass thru subcutaneous tunnel routes.
Methods : From November 2007 to October 2015, 5 patients were enrolled and median age is 59 years old (range: 53-85, two octogenarians). Their accompanying diseases were coronary artery disease in 4, critical limb ischemia in 2, quadriplegia in 1 and pulmonary thromboembolism + deep vein thrombosis + LAA thrombus in 1 patient, respectively. Bed-ridden status was in 3 patients. Concomitant CABG was conducted in 4 patients (on-pump in 1 and off-pump in 3 patients, respectively / redo OPCAB in one patient) and numbers of coronary anastomosis were 2 (range: 1-2). Access routes to ascending aorta were full-sternotomy in 3, Rt. para-sternal incision in 1 and upper-half sternotomy in 1 patient, respectively.
Results : Median op time is 340 minutes (range: 185-410), and there was no on-pump conversion in OPCAB cases. Postop ICU-stay and hospital-stay are 6 days (range: 2-14) and 28 days (range: 11-289), respectively. There were no operative mortality, one follow-up mortality case (bed-ridden, redo OPCAB, unknown at postoperative 315 days) and 3 morbidities (pleural effusion, sacral pressure sore and wound dehiscence needs re-closure). Mean survival time is 6.815 years (95% C.I. 3.446-10.184) and 8-year survival rate is 75%. Mean graft-patency time is 8.53 years (95% C.I. 8.530-8.530) and 8-year patency rate is also 100% by CT angiogram or ultrasound exam.
Conclusion : Conducting extra-anatomic abdomen-sparing ascending aorto-femoral artery bypass surgery is feasible for mid-aortic disease and its results are acceptable.
Methods : From November 2007 to October 2015, 5 patients were enrolled and median age is 59 years old (range: 53-85, two octogenarians). Their accompanying diseases were coronary artery disease in 4, critical limb ischemia in 2, quadriplegia in 1 and pulmonary thromboembolism + deep vein thrombosis + LAA thrombus in 1 patient, respectively. Bed-ridden status was in 3 patients. Concomitant CABG was conducted in 4 patients (on-pump in 1 and off-pump in 3 patients, respectively / redo OPCAB in one patient) and numbers of coronary anastomosis were 2 (range: 1-2). Access routes to ascending aorta were full-sternotomy in 3, Rt. para-sternal incision in 1 and upper-half sternotomy in 1 patient, respectively.
Results : Median op time is 340 minutes (range: 185-410), and there was no on-pump conversion in OPCAB cases. Postop ICU-stay and hospital-stay are 6 days (range: 2-14) and 28 days (range: 11-289), respectively. There were no operative mortality, one follow-up mortality case (bed-ridden, redo OPCAB, unknown at postoperative 315 days) and 3 morbidities (pleural effusion, sacral pressure sore and wound dehiscence needs re-closure). Mean survival time is 6.815 years (95% C.I. 3.446-10.184) and 8-year survival rate is 75%. Mean graft-patency time is 8.53 years (95% C.I. 8.530-8.530) and 8-year patency rate is also 100% by CT angiogram or ultrasound exam.
Conclusion : Conducting extra-anatomic abdomen-sparing ascending aorto-femoral artery bypass surgery is feasible for mid-aortic disease and its results are acceptable.
책임저자: Doosang Kim
Department of Thoracic and Cardiovascular Surgery, Veterans Health Service Medical Center, Seoul, Korea
발표자: Doosang Kim, E-mail : mdksr@paran.com