Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 733-738, 2005.
Artigo
em Coreano
| WPRIM
| ID: wpr-166027
ABSTRACT
BACKGROUND:
The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. MATERIAL ANDMETHOD:
From January 1998 to July 2004, 25 (3.2%) patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was performed before CABG in 8 patients and after CABG in 17 patients.RESULT:
The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial graft available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was 2.3+/-1.0. Mean number of lesions treated by PCI was 1.2+/-0.4. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography (1.8+/-1.6 days) revealed 100% patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; 25+/-26 months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents.CONCLUSION:
In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Aorta
/
Fibrilação Atrial
/
Angioplastia Coronária com Balão
/
Stents
/
Ponte de Artéria Coronária
/
Seguimentos
/
Mortalidade
/
Angiografia Coronária
/
Sobreviventes
/
Procedimentos Cirúrgicos Minimamente Invasivos
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Coreano
Revista:
The Korean Journal of Thoracic and Cardiovascular Surgery
Ano de publicação:
2005
Tipo de documento:
Artigo
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