The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG / 대한흉부외과학회지

Background: With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with those having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-six patients underwent on-pump CABG, fifty-one patinents underwent off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups. Result: There were no differences in their sex ratios, ages, preoperative risk factors, preoperative MI, Canadian classes, extent of coronary artery diseases and, echocardiographic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270+/-79.3 min vs 372+/-142.2 min, p<0.001), mean ventilation time (17.1+/-13.1 hr vs 24.3+/-17.8 hr) and CK-MB level (8.9+/-18.7 IU/L vs 25.7+/-8.4 IU/L) than on-pump CABG groups. On-pump CABG group had more distal grafts (2.2+/-0.5 vs 1.7+/-0.7) than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

Atypical Middle Aortic Syndrome in a Middle Aged Woman: A case report / 대한흉부외과학회지

The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called "middle aortic syndrome" or "mid-aortic dyspastic syndrome". Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.