초록접수 현황
| 20F-085 | 구연 발표 |
Transit-time flow predicts outcomes in coronary artery bypass graft patients: a series of 1300 sequential vein grafts
Hyo-Hyun Kim, Jung-hwan Kim, Hyun-Chel Choo, Seung Hyun Lee, Sak Lee, Kyung-Jong Yoo, Young-Nam Youn
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
Purpose : Transit time flowmetry (TTFM) has been widely used during coronary artery bypass grafting surgery (CABG) for intraoperative graft assessment. This study aimed to investigate whether TTFM values are predictive the graft failure and major adverse cardiac events (MACE).
Methods : Between 2011 and 2018, 1,933 patients with three-vessel coronary artery disease that underwent off-pump coronary artery bypass (OPCAB) were analyzed retrospectively. Among them, 1288 of sequential venous grafts were measured to TTFM’s two parameters, pulsatility index (PI) and flow (mL/min) in 538 consecutive patients. We divided them into three groups [group A; 1st side-to-side anastomoses (n=538), group B; 2nd side-to-side (n=212), group C; end-to-side (n=538)]. Major adverse cardia events (MACEs: recurrent angina, perioperative myocardial infarction, postoperative angioplasty, re-operation and/or perioperative death) were assessed to related to TTFM. The mean follow-up time was 5.4±4.2 years.
Results : Five-year survival was 93.7%. Mean graft flow was 59.1±31.3, 41.0±25.2, 38.9±22.8 mL/minute in A, B and C group; and pulsatility index was 3.2±1.3, 3.5±3.4, 3.4±2.5, respectively (Table 1). Postoperative graft patency confirmed with multislice computed tomography or coronary angiography (follow-up interval: 27.8±20.5 months). Graft failure occurred in 8/538 (1.5%) patients, and MACE rate was 3.3% (43/1288 grafts) (Table 2). Multivariable logistic analysis showed the high PI (>5; HR 2.276; 95%CI 2.188-2.406, p<0.001) as an independent risk factor of MACEs. The cutoff value of PI of sequential graft was serially 3.65, 3.55 and 3.17 for prediction of MACEs.
Conclusion : A high PI predicts the poor outcomes of sequential venous grafts after surgery, and different cut-off values could by applied depending on the anastomotic location.
Methods : Between 2011 and 2018, 1,933 patients with three-vessel coronary artery disease that underwent off-pump coronary artery bypass (OPCAB) were analyzed retrospectively. Among them, 1288 of sequential venous grafts were measured to TTFM’s two parameters, pulsatility index (PI) and flow (mL/min) in 538 consecutive patients. We divided them into three groups [group A; 1st side-to-side anastomoses (n=538), group B; 2nd side-to-side (n=212), group C; end-to-side (n=538)]. Major adverse cardia events (MACEs: recurrent angina, perioperative myocardial infarction, postoperative angioplasty, re-operation and/or perioperative death) were assessed to related to TTFM. The mean follow-up time was 5.4±4.2 years.
Results : Five-year survival was 93.7%. Mean graft flow was 59.1±31.3, 41.0±25.2, 38.9±22.8 mL/minute in A, B and C group; and pulsatility index was 3.2±1.3, 3.5±3.4, 3.4±2.5, respectively (Table 1). Postoperative graft patency confirmed with multislice computed tomography or coronary angiography (follow-up interval: 27.8±20.5 months). Graft failure occurred in 8/538 (1.5%) patients, and MACE rate was 3.3% (43/1288 grafts) (Table 2). Multivariable logistic analysis showed the high PI (>5; HR 2.276; 95%CI 2.188-2.406, p<0.001) as an independent risk factor of MACEs. The cutoff value of PI of sequential graft was serially 3.65, 3.55 and 3.17 for prediction of MACEs.
Conclusion : A high PI predicts the poor outcomes of sequential venous grafts after surgery, and different cut-off values could by applied depending on the anastomotic location.
책임저자: Young-Nam Youn
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea
발표자: Young-Nam Youn, E-mail : ynyoun@yuhs.ac