초록접수 현황
| 17F-075 | 구연 발표 |
Bilateral Versus Single Internal Thoracic Artery: Which One is Better in the Patients with LV Dysfunction?
Suryeun Chung, Sang Yoon Kim, Dong Jung Kim, Jun Sung Kim, Kay-Hyun Park, Cheong Lim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Use of the bilateral internal thoracic arteries (ITA) has been considered as a better option in terms of improved survival and fewer cardiac events compared with single ITA. We investigated our experience to compare the clinical outcomes and long-term survival between single (SITA) and bilateral ITA (BITA) grafting in the patients with LV dysfunction.
Methods : From 2003 and 2017, 230 patients with LV dysfunction (EF≤40%) underwent isolated CABG. Among them, 167 patients (72.6%) received BITA grafting and 63 patients (27.4%) received SITA grafting. We compared the clinical outcomes and target vessel revascularization rate. Propensity score-matched analysis was performed in two groups (28 patients each) to eliminate the preoperative selection bias.
Results : Overall, there was no difference between groups for early mortality (4.8% vs 11.0%, p=0.07), and incidence of deep sternal infection or mediastinitis (1.8% vs 4.8%, p=0.34). Mean follow-up duration was 51 months (0~182 months). Survival and freedom from MACCES at 5 years were significantly better in BITA group (75.6±0.04% vs 52.1±0.06%, p<0.01 and 75.6±0.03% vs 52.1±0.06%, p<0.01), respectively. In propensity score-matched analysis, BITA group showed also better results in overall survival (80.6±0.01% vs 68.1±0.06% p=0.03) and freedom from MACCES (80.6±0.01%vs 68.1±0.06% p=0.03). However, freedom from target vessel revascularization (TVR) was not different in both groups, regardless of matching.
Conclusion : BITA showed better results in terms of long-term survival and MACC-free survival compared with SITA in the patients with LV dysfunction. Incidence of wound problem was not different in both groups.
Methods : From 2003 and 2017, 230 patients with LV dysfunction (EF≤40%) underwent isolated CABG. Among them, 167 patients (72.6%) received BITA grafting and 63 patients (27.4%) received SITA grafting. We compared the clinical outcomes and target vessel revascularization rate. Propensity score-matched analysis was performed in two groups (28 patients each) to eliminate the preoperative selection bias.
Results : Overall, there was no difference between groups for early mortality (4.8% vs 11.0%, p=0.07), and incidence of deep sternal infection or mediastinitis (1.8% vs 4.8%, p=0.34). Mean follow-up duration was 51 months (0~182 months). Survival and freedom from MACCES at 5 years were significantly better in BITA group (75.6±0.04% vs 52.1±0.06%, p<0.01 and 75.6±0.03% vs 52.1±0.06%, p<0.01), respectively. In propensity score-matched analysis, BITA group showed also better results in overall survival (80.6±0.01% vs 68.1±0.06% p=0.03) and freedom from MACCES (80.6±0.01%vs 68.1±0.06% p=0.03). However, freedom from target vessel revascularization (TVR) was not different in both groups, regardless of matching.
Conclusion : BITA showed better results in terms of long-term survival and MACC-free survival compared with SITA in the patients with LV dysfunction. Incidence of wound problem was not different in both groups.
책임저자: Cheong Lim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Suryeun Chung, E-mail : suryeun.chung@gmail.com