초록접수 현황
| 17F-018 | 구연 발표 |
Saphenous Vein as a Composite Graft: Clinical Outcomes and Patency Compared with Aorto-coronary Graft
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Kyung-Jong Yoo, Young-Nam Youn
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : To study the clinical outcomes and patency of composite saphenous vein graft (SVG) compared with aorto-coronary graft.
Methods : From January 2001 to December 2014, 878 patients underwent isolated off-pump coronary artery bypass with SVG. And 657 patients were performed computed tomography (CT) or coronary angiography (CAG) to identify the graft patency, and enrolled in this study. Enrolled patients were divided into two groups: SVG as aorto-coronary graft (n=442, A-group) and as composite graft (n=215, C-group). Mean follow-up duration was 6.7±3.3 years and mean CT/CAG duration was 2.4±3.0 years.
Results : After propensity-score matching, baseline characteristics were comparable between the groups (n=215 in each group). Overall survival (77.5±6.1% in A-group vs. 63.4±5.7% in C-group, p=0.029) at 15-years was significantly higher in A-group. SVG patency at 10-years was also significantly higher in A-group (88.4±4.7% vs. 35.5±13.1%, p<0.001). SVG patency that was anastomosed to LAD/LCX territory was not significantly different between the groups, but that was anastomosed to RCA territory was significantly higher in A-group (93.5±2.7% vs. 70.3±6.2%, p=0.002). SVG patency that was anastomosed to severe-stenotic lesion was not significantly different between the groups, but that was anastomosed to mild (100% vs. 48.0±17.7%, p=0.002) and moderate (83.3±8.8% vs. 19.4±14.8%, p<0.001) stenotic lesion was significantly higher in A-group. Multivariate analysis showed that composite-SVG was a risk factor of graft occlusion (HR=3.511, 95%CI=1.694-7.277, p=0.001) and late death (HR=1.696, 95%CI=1.018-2.827, p=0.043).
Conclusion : SVG as a composite graft increased the risk of graft occlusion and late death. SVG should be used as aorto-coronary graft on mild-to-moderate stenotic lesion or RCA territory.
Methods : From January 2001 to December 2014, 878 patients underwent isolated off-pump coronary artery bypass with SVG. And 657 patients were performed computed tomography (CT) or coronary angiography (CAG) to identify the graft patency, and enrolled in this study. Enrolled patients were divided into two groups: SVG as aorto-coronary graft (n=442, A-group) and as composite graft (n=215, C-group). Mean follow-up duration was 6.7±3.3 years and mean CT/CAG duration was 2.4±3.0 years.
Results : After propensity-score matching, baseline characteristics were comparable between the groups (n=215 in each group). Overall survival (77.5±6.1% in A-group vs. 63.4±5.7% in C-group, p=0.029) at 15-years was significantly higher in A-group. SVG patency at 10-years was also significantly higher in A-group (88.4±4.7% vs. 35.5±13.1%, p<0.001). SVG patency that was anastomosed to LAD/LCX territory was not significantly different between the groups, but that was anastomosed to RCA territory was significantly higher in A-group (93.5±2.7% vs. 70.3±6.2%, p=0.002). SVG patency that was anastomosed to severe-stenotic lesion was not significantly different between the groups, but that was anastomosed to mild (100% vs. 48.0±17.7%, p=0.002) and moderate (83.3±8.8% vs. 19.4±14.8%, p<0.001) stenotic lesion was significantly higher in A-group. Multivariate analysis showed that composite-SVG was a risk factor of graft occlusion (HR=3.511, 95%CI=1.694-7.277, p=0.001) and late death (HR=1.696, 95%CI=1.018-2.827, p=0.043).
Conclusion : SVG as a composite graft increased the risk of graft occlusion and late death. SVG should be used as aorto-coronary graft on mild-to-moderate stenotic lesion or RCA territory.
책임저자: Young-Nam Youn
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