초록접수 현황
| 16F-273 | 구연 발표 |
The Comparison of Long-term Clinical Outcomes after off-pump Coronary Artery Bypass between the Bilateral Internal Thoracic Artery and Single Internal Thoracic Artery in Elderly Patients.
Do Jung Kim, Hyun-chel Joo, Seung-hyun Lee, Sak Lee, Byung-Chul Chang, Kyung-Jong Yoo, Young-Nam Youn
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Benefit of bilateral internal thoracic artery (ITA) graft in elderly patients has not been determined. The purpose of our study was to evaluate long-term clinical outcomes of BITA and SITA grafting after off-pump coronary artery bypass (OPCAB) in patients older than 70 years.
Methods : : From 2001 to 2010, a total of 1,550 patients with isolated OPCAB by two experienced surgeons were analyzed retrospectively. 99 patients who underwent BITA grafting were compared with 316 patients who underwent SITA grafting in coronary revascularization of patients aged 70 years or older. 99 BITA patients could be pair-wise propensity matched to a SITA patient. The end points were in-hospital mortality, overall survival and major adverse cardiac and cerebral events (MACCE). The mean follow-up duration was 6.3±3.01 years (range, 0.1 to 14.6 years).
Results : The mean age (year) was 73.4±2.9 in BITA group and 73.7±3.2 in SITA group (p=0.32). After propensity-score matching, the in-hospital mortality and other early complications were similar. There were no significant difference in the incidence of stroke (n=5, 5.1% for SITA and n=8, 8.1% for BITA; p=0.39), myocardial infarction (n=1, 1.0% for SITA and n=0, 0% for BITA; p=0.99) and target vessel revascularization (n=7, 7.1% for SITA and n=9, 9.1% for BITA, p =0.60) between two groups. The overall survival rate at 15 years were 79.2±4.9% in SITA group and 71.1±5.3% in BITA group (p=0.66). The overall freedom from MACCEs rates at 15 years were 67.8±5.2% in SITA and 55.1±6.0% in BITA group. (p=0.58).
Conclusion : BITA grafting did not showed an advantage over SITA grafting in terms of overall survival and MACCEs at 15 years in patients older than 70 years underwent OPCAB. Longer follow-up is needed to clarify these results.
Methods : : From 2001 to 2010, a total of 1,550 patients with isolated OPCAB by two experienced surgeons were analyzed retrospectively. 99 patients who underwent BITA grafting were compared with 316 patients who underwent SITA grafting in coronary revascularization of patients aged 70 years or older. 99 BITA patients could be pair-wise propensity matched to a SITA patient. The end points were in-hospital mortality, overall survival and major adverse cardiac and cerebral events (MACCE). The mean follow-up duration was 6.3±3.01 years (range, 0.1 to 14.6 years).
Results : The mean age (year) was 73.4±2.9 in BITA group and 73.7±3.2 in SITA group (p=0.32). After propensity-score matching, the in-hospital mortality and other early complications were similar. There were no significant difference in the incidence of stroke (n=5, 5.1% for SITA and n=8, 8.1% for BITA; p=0.39), myocardial infarction (n=1, 1.0% for SITA and n=0, 0% for BITA; p=0.99) and target vessel revascularization (n=7, 7.1% for SITA and n=9, 9.1% for BITA, p =0.60) between two groups. The overall survival rate at 15 years were 79.2±4.9% in SITA group and 71.1±5.3% in BITA group (p=0.66). The overall freedom from MACCEs rates at 15 years were 67.8±5.2% in SITA and 55.1±6.0% in BITA group. (p=0.58).
Conclusion : BITA grafting did not showed an advantage over SITA grafting in terms of overall survival and MACCEs at 15 years in patients older than 70 years underwent OPCAB. Longer follow-up is needed to clarify these results.
책임저자: Young-Nam Youn
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Do Jung Kim, E-mail : phalcorpse@yuhs.ac