초록접수 현황
| 20F-162 | 구연 발표 |
Comparison of Mid-term Outcomes between Sutureless and Conventional Aortic Valve Replacement with Concomitant Coronary Artery Bypass Grafting
Min-Seok Kim, Jung Whan Kim, Hyun-Chel Joo, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Seung Hyun Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Purpose : The objectives of the present study were (1)to compare the mid-term outcomes in patients who received sutureless versus conventional aortic valve replacement(AVR) with concomitant coronary artery bypass grafting(CABG), and (2)to evaluate the risk factors associated with worse outcomes in those patients.
Methods : Of 136 patients who underwent AVR and concomitant CABG from 2015 to 2019, 86 patients who underwent AVR using tissue valve(median age, 74.7[71.0, 78.2] years; female, 32/86(37.2%)) were included in the present study. Patients who underwent sutureless AVR(group S, N=40) were compared with those who underwent conventional AVR(group C, N=46). The differences in postoperative clinical outcomes, overall survival, freedom from cardiac death were analyzed, and risk factors of mortality were identified.
Results : No patients underwent reoperation due to prosthetic valve failure during the follow-up period. Group S showed a shorter aortic cross-clamp(ACC) time than group C(78.9±35.0 vs. 99.9±39.3 minutes, P=0.011). However, no significant differences were observed in cardiopulmonary bypass time, length of hospital stay, and permanent pacemaker implantation (P=0.096, 0.933, and 0.414, respectively). Overall survival rates at postoperative 5 years were 84.8% and 83.1%, in groups S and C, respectively(P=0.6). Cardiac mortality-free survival rates at postoperative 5 years were 87.0% and 87.0% in groups S and C, respectively(P=0.3). Preoperative creatinine level (HR 1.43; 95% CI 1.15-1.80; P=0.002) and severity of tricuspid regurgitation(HR 1.87; 95% CU 1.07-3.27; P=0.029) were analyzed to be risk factors of all-cause mortality
Conclusion : Sutureless AVR decreased ACC time, however, showed similar early and midterm results compared to conventional AVR in patients who required concomitant CABG.
Methods : Of 136 patients who underwent AVR and concomitant CABG from 2015 to 2019, 86 patients who underwent AVR using tissue valve(median age, 74.7[71.0, 78.2] years; female, 32/86(37.2%)) were included in the present study. Patients who underwent sutureless AVR(group S, N=40) were compared with those who underwent conventional AVR(group C, N=46). The differences in postoperative clinical outcomes, overall survival, freedom from cardiac death were analyzed, and risk factors of mortality were identified.
Results : No patients underwent reoperation due to prosthetic valve failure during the follow-up period. Group S showed a shorter aortic cross-clamp(ACC) time than group C(78.9±35.0 vs. 99.9±39.3 minutes, P=0.011). However, no significant differences were observed in cardiopulmonary bypass time, length of hospital stay, and permanent pacemaker implantation (P=0.096, 0.933, and 0.414, respectively). Overall survival rates at postoperative 5 years were 84.8% and 83.1%, in groups S and C, respectively(P=0.6). Cardiac mortality-free survival rates at postoperative 5 years were 87.0% and 87.0% in groups S and C, respectively(P=0.3). Preoperative creatinine level (HR 1.43; 95% CI 1.15-1.80; P=0.002) and severity of tricuspid regurgitation(HR 1.87; 95% CU 1.07-3.27; P=0.029) were analyzed to be risk factors of all-cause mortality
Conclusion : Sutureless AVR decreased ACC time, however, showed similar early and midterm results compared to conventional AVR in patients who required concomitant CABG.
책임저자: Seung Hyun Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
발표자: Min-Seok Kim, E-mail : mesmerist84@gmail.com