Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 643-652, 2002.
Article
in Korean
| WPRIM
| ID: wpr-49230
ABSTRACT
BACKGROUND:
As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. MATERIAL ANDMETHOD:
From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of 61.8+/-9.1 years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients.RESULT:
Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was 3.2+/-1.0. There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was 96.6+/-35.3 minutes and the mean CPB time was 179.2+/-94.6 minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age(>or= 70 years), poor LV function(EF < 40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was 39.0+/-27.0 months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8%) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result.CONCLUSION:
The operative and late results of CABG in our hospital was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aorta
/
Outpatients
/
Arrhythmias, Cardiac
/
Arteries
/
Recurrence
/
Saphenous Vein
/
Shock, Cardiogenic
/
Surgical Procedures, Operative
/
Cardiac Output, Low
/
Coronary Artery Bypass
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Korean
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2002
Type:
Article
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