초록접수 현황
| 16F-263 | 구연 발표 |
Contemporary Outcomes of Coronary Artery Bypass in Severe Left Ventricular Systolic Dysfunction; A Single Center Experience
Man-shik Shim, Wook Sung Kim, Dong Seop Jeong, Young Tak Lee
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
목적 : Despite a higher operative risk, recent randomized trial showed survival benefit of surgical revascularization in patients with severe left ventricular(LV) dysfunction. The aim of the present study was to assess the early and late outcomes of those patients undergoing coronary artery bypass grafting(CABG).
방법 : Between January 2001 and December 2014, outcomes of 436 consecutive patients with severe LV dysfunction (left ventricular ejection fraction [LVEF] ≤ 35%) undergoing isolated CABG were analyzed retrospectively. The subjects were divided into three subgroups base on LVEF (Group 1[N=47]; <20%, Group 2[N=206]; 21-30%, Group 3[N=183]; 31-35%).
결과 : Overall early mortality was 4.6%. Early mortality was statistically significantly higher in patients with a lower EF (17% vs. 5.3% vs. 0.5%, p < 0.001; Cochran Armitage test). Multivariate logistic regression analysis identified extremely low LVEF (<20%), advanced age (>70 years old), significant carotid artery stenosis as an independent risk factor for early mortality. One-hundred forty-one patients were expired during the follow-up. 5-year and 10-year survival rate were 76.3% and 55.2%, respectively. Lower LVEF was not a risk factor of late mortality (p=0.967, Cox proportional Hazard).
결론 : CABG in patients with severe LV dysfunction can be performed with a low mortality. Extremely severe LV dysfunction was a risk factor of early mortality, but not of late mortality.
방법 : Between January 2001 and December 2014, outcomes of 436 consecutive patients with severe LV dysfunction (left ventricular ejection fraction [LVEF] ≤ 35%) undergoing isolated CABG were analyzed retrospectively. The subjects were divided into three subgroups base on LVEF (Group 1[N=47]; <20%, Group 2[N=206]; 21-30%, Group 3[N=183]; 31-35%).
결과 : Overall early mortality was 4.6%. Early mortality was statistically significantly higher in patients with a lower EF (17% vs. 5.3% vs. 0.5%, p < 0.001; Cochran Armitage test). Multivariate logistic regression analysis identified extremely low LVEF (<20%), advanced age (>70 years old), significant carotid artery stenosis as an independent risk factor for early mortality. One-hundred forty-one patients were expired during the follow-up. 5-year and 10-year survival rate were 76.3% and 55.2%, respectively. Lower LVEF was not a risk factor of late mortality (p=0.967, Cox proportional Hazard).
결론 : CABG in patients with severe LV dysfunction can be performed with a low mortality. Extremely severe LV dysfunction was a risk factor of early mortality, but not of late mortality.
책임저자: Young Tak Lee
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Man-shik Shim, E-mail : mdshmsh@naver.com