Clinical Analysis of the Early Result of Coronary Artery bypass Graft / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Recently, coronary artery obstructive disease and coronary artery bypass graft surgery have increased, and the operative result has been improved. We reviewed 154 cases of coronary artery bypass graft surgery from Jan. 1985 to Jun. 2004. MATERIAL AND METHOD: We reviewed 148 patients, 154 cases of coronary artery bypass surgery from Jan. 1985 to Jun. 2004. This investigation is designed to illustrate the preoperative diagnosis, severity of disease, operative method, the kind of used bypass graft used, number of distal anasomosis, associated surgery, and postoperative morbidity and mortality. RESULT: There were 84 males, 64 females and the average age was 58.9+/-8.3 years old. Preoperative clinical diagnosis were unstable angina in 97 cases (63.0%), stable angina in 31 cases (20.1%), acute myocardial infarction in 12 cases (7.8%) and postinfartion angina in 14 cases (9.1%). Preoperative angiographic diagnosis were three-vessel disease in 68 (44.2%), two-vessel disease in 39 (25.3%), one-vessel disease in 35 (22.7%), and left main disease in 12 (7.8%) cases. There were 78 cases of on-pump coronary artery bypass graft surgery and 76 cases of off-pump coronary artery bypass graft surgery. The total distal anastomoses number was 319, mean number of anastomoses was 2.06+/-0.96. There were 10 concomitant procedures. Postoperative intra-aortic balloon pump was used in 21 (13.6%) cases, but only 4 cases were used at off-pump coronary artery bypass surgery. Total early mortality was 7.8%. The mortality was decreased as 4.5% from Jan. 2001 to Jun. 2004. Post operative complication was perioperative myocardial infarction in 9 cases (5.8%), low cardiac output syndrome in 17 cases (11%), and arrhythmia in 30 cases (19.5%) cases. CONCLUSION: Since 1985, The result of coronary artery bypass graft surgery has been improved because of more refined technique, use of off-pump coronary artery bypass surgery, use of internal thoracic artery and radial artery as bypass graft. We should study the long-term follow up more for better operative results.