초록접수 현황
| 20F-191 | 구연 발표 |
Left Internal Thoracic Artery Failure and Subsequent Clinical Outcomes after Off-Pump Coronary Artery Bypass Grafting
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Kyung-Jong Yoo, Young-Nam Youn
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Purpose : We studied the relationship between left internal thoracic artery (LITA) graft failure and subsequent long-term clinical outcomes after off-pump coronary artery bypass grafting (OPCAB).
Methods : Between January 2001 and December 2014, 2520 patients underwent isolated OPCAB. And 1009 patients performed computed tomography (CT) or coronary angiography (CAG) to identify the graft patency at least 12 months after surgery and enrolled in this study. Graft failure was defined as a ≥80% stenosis or occlusion at follow-up CT or CAG. The clinical outcomes were assessed with major adverse cardiac events (all-cause mortality, non-fatal myocardial infarction [MI], and target vessel revascularization [TVR]). The mean follow-up duration was 11.4±3.8 years and the mean CT/CAG follow-up duration was 6.1±3.8 years.
Results : During follow-up period, LITA graft failure was identified in 69 patients (6.8%). LITA failure group showed similar 10-year survival rate compared with patent group (88.0±0.4% in failure group vs. 89.5±0.1% in patent group, p=0.52). However, LITA failure independently increased the risk of TVR (adjusted HR=9.32 [6.17-14.07], p<0.01) and non-fatal MI (adjusted HR=3.65 [1.75-7.62], p<0.01). Multivariate analysis showed that mild stenosis degree (<70%) (adjusted HR=5.97 [2.95-12.08], p<0.01) and moderate stenosis degree (70% to 89%) (adjusted HR=2.79 [1.53-5.08], p<0.01) of native left anterior descending artery were independent risk factors for LITA failure compared with severe stenosis (≥90%).
Conclusion : LITA failure was associated with higher rates of TVR and non-fatal MI, but showed similar long-term survival compared with LITA patent patients. And mild to moderate (<90%) left anterior descending artery stenosis significantly increased the risk of LITA failure.
Methods : Between January 2001 and December 2014, 2520 patients underwent isolated OPCAB. And 1009 patients performed computed tomography (CT) or coronary angiography (CAG) to identify the graft patency at least 12 months after surgery and enrolled in this study. Graft failure was defined as a ≥80% stenosis or occlusion at follow-up CT or CAG. The clinical outcomes were assessed with major adverse cardiac events (all-cause mortality, non-fatal myocardial infarction [MI], and target vessel revascularization [TVR]). The mean follow-up duration was 11.4±3.8 years and the mean CT/CAG follow-up duration was 6.1±3.8 years.
Results : During follow-up period, LITA graft failure was identified in 69 patients (6.8%). LITA failure group showed similar 10-year survival rate compared with patent group (88.0±0.4% in failure group vs. 89.5±0.1% in patent group, p=0.52). However, LITA failure independently increased the risk of TVR (adjusted HR=9.32 [6.17-14.07], p<0.01) and non-fatal MI (adjusted HR=3.65 [1.75-7.62], p<0.01). Multivariate analysis showed that mild stenosis degree (<70%) (adjusted HR=5.97 [2.95-12.08], p<0.01) and moderate stenosis degree (70% to 89%) (adjusted HR=2.79 [1.53-5.08], p<0.01) of native left anterior descending artery were independent risk factors for LITA failure compared with severe stenosis (≥90%).
Conclusion : LITA failure was associated with higher rates of TVR and non-fatal MI, but showed similar long-term survival compared with LITA patent patients. And mild to moderate (<90%) left anterior descending artery stenosis significantly increased the risk of LITA failure.
책임저자: Young-Nam Youn
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac