초록접수 현황
| 17F-234 | 구연 발표 |
Subclavian Artery Cannulation Can Reduce the Early Embolic Stroke after Open Arch Surgery with Circulatory Arrest
Jung-Hwan Kim, Seung Hyun Lee, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Byung-Chel Chang, Hyun-Chel Joo
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : To study the impact of subclavian artery cannulation on early embolic stroke after open arch surgery with circulatory arrest.
Methods : From January 2006 to May 2017, 309 patients underwent open arch surgery (including hemi, partial, or total arch) with circulatory arrest. Embolic stroke was defined as a physician-diagnosed new postoperative neurologic deficit lasting more than 72 hours, generally confirmed by computed tomography or magnetic resonance imaging. End-points were post-operative early embolic stroke and early mortality. The mean follow-up duration was 3.9±3.1 years.
Results : The mean age was 62.8 years and 165 (53.4%) were male. Subclavian artery was used for arterial cannulation in 216 (69.9%, Subclavian group) patients and not be used in 93 (30.1%, Non-subclavian group) patients. Subclavian group had more patients with chronic obstructive pulmonary disease (19.4% vs. 8.6%, p=0.018) and coronary artery disease (28.2% vs. 17.2%, p=0.040) than Non-subclavian group. And total-arch replacement was performed more in Subclavian group than Non-subclavian group (37.0% vs. 14.0%, p<0.001). There was no significant difference in emergency operation between the groups (31.1% vs. 33.3%, p=0.572). The incidence of early embolic stroke was significantly higher in Non-subclavian group (3.7% vs. 9.7%, p=0.035) and 30-day mortality was also significantly higher in Non-subclavian group (3.2% vs. 9.7%, p=0.026). Multivariate analysis showed that subclavian cannulation was a protective predictor of stroke (OR=0.172 [0.038-0.782], p=0.023) and 30-day mortality (OR=0.261 [0.069-0.993], p=0.049).
Conclusion : Subclavian artery cannulation can reduce the early embolic stroke and early mortality after open arch surgery with circulatory arrest.
Methods : From January 2006 to May 2017, 309 patients underwent open arch surgery (including hemi, partial, or total arch) with circulatory arrest. Embolic stroke was defined as a physician-diagnosed new postoperative neurologic deficit lasting more than 72 hours, generally confirmed by computed tomography or magnetic resonance imaging. End-points were post-operative early embolic stroke and early mortality. The mean follow-up duration was 3.9±3.1 years.
Results : The mean age was 62.8 years and 165 (53.4%) were male. Subclavian artery was used for arterial cannulation in 216 (69.9%, Subclavian group) patients and not be used in 93 (30.1%, Non-subclavian group) patients. Subclavian group had more patients with chronic obstructive pulmonary disease (19.4% vs. 8.6%, p=0.018) and coronary artery disease (28.2% vs. 17.2%, p=0.040) than Non-subclavian group. And total-arch replacement was performed more in Subclavian group than Non-subclavian group (37.0% vs. 14.0%, p<0.001). There was no significant difference in emergency operation between the groups (31.1% vs. 33.3%, p=0.572). The incidence of early embolic stroke was significantly higher in Non-subclavian group (3.7% vs. 9.7%, p=0.035) and 30-day mortality was also significantly higher in Non-subclavian group (3.2% vs. 9.7%, p=0.026). Multivariate analysis showed that subclavian cannulation was a protective predictor of stroke (OR=0.172 [0.038-0.782], p=0.023) and 30-day mortality (OR=0.261 [0.069-0.993], p=0.049).
Conclusion : Subclavian artery cannulation can reduce the early embolic stroke and early mortality after open arch surgery with circulatory arrest.
책임저자: Hyun-Chel Joo
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac