초록접수 현황
| 17F-248 | 구연 미채택시 포럼 발표 |
Clinical Usefulness of Preoperative Thoracoabdominal Multidetector Computed Tomographic Angiography in Patients undergoing Coronary Artery Bypass Grafting
Kwon Joong Na, Jae-Woong Choi, Ho Young Hwang, Ki-Bong Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Multidetector computed tomographic(MDCT) cardiac angiography is widely used for evaluating atherosclerotic status of aorta and its major branches. The aims of this study were to assess the prevalence of incidental findings(IF) with significance in preoperative thoracoabdominal MDCT angiography, and their clinical significance in patients undergoing coronary artery bypass grafting(CABG).
Methods : Among 456 patient who underwent isolated CABG between 2014 and 2016, we retrospectively reviewed 442 patients (96.9%) who underwent preoperative thoracoabdominal MDCT angiography (mean age 66.1±10.3 years; Male:Female=316:126). All IF with significance which influenced perioperative management and needed additional intervention or follow-up were reviewed and analyzed.
Results : Significant atherosclerotic findings affecting perioperative management were found in 176 patients (39.5%), including severe stenosis or occlusion of neck vessels (n=70), and iliofemoral arteries (n=90), left subclavian artery stenosis (n=5), and severe calcification of ascending aorta and arch (n=66). Two patients (0.2%) needed intervention for abdominal aortic aneurysm. Other IF with significance were found in 45 patients (10.7%). Multivariate analysis demonstrated that age (>60 years) and chronic renal failure were predisposing factors for significant atherosclerotic findings. Internal thoracic arteries were evaluated in 119 patients (26.9%) whose internal thoracic arteries were not evaluated by preoperative coronary angiography, and iliofemoral vessels were evaluated in 30 patients (6.8%) who underwent intra-aortic balloon pump therapy during perioperative period.
Conclusion : Considering high prevalence of IF with significance in approximately half of the patients and additional preoperative information in one-third of patients, thoracoabdominal MDCT angiography should be performed in preoperative CABG patients, especially in elderly and who have chronic renal failure.
Methods : Among 456 patient who underwent isolated CABG between 2014 and 2016, we retrospectively reviewed 442 patients (96.9%) who underwent preoperative thoracoabdominal MDCT angiography (mean age 66.1±10.3 years; Male:Female=316:126). All IF with significance which influenced perioperative management and needed additional intervention or follow-up were reviewed and analyzed.
Results : Significant atherosclerotic findings affecting perioperative management were found in 176 patients (39.5%), including severe stenosis or occlusion of neck vessels (n=70), and iliofemoral arteries (n=90), left subclavian artery stenosis (n=5), and severe calcification of ascending aorta and arch (n=66). Two patients (0.2%) needed intervention for abdominal aortic aneurysm. Other IF with significance were found in 45 patients (10.7%). Multivariate analysis demonstrated that age (>60 years) and chronic renal failure were predisposing factors for significant atherosclerotic findings. Internal thoracic arteries were evaluated in 119 patients (26.9%) whose internal thoracic arteries were not evaluated by preoperative coronary angiography, and iliofemoral vessels were evaluated in 30 patients (6.8%) who underwent intra-aortic balloon pump therapy during perioperative period.
Conclusion : Considering high prevalence of IF with significance in approximately half of the patients and additional preoperative information in one-third of patients, thoracoabdominal MDCT angiography should be performed in preoperative CABG patients, especially in elderly and who have chronic renal failure.
책임저자: Ki-Bong Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Kwon Joong Na, E-mail : kjna85@gmail.com