Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Long-term Survival after Coronary Artery bypass Surgery

관상동맥 우회술의 장기 생존율

  • Lee Mi Kyung (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine) ;
  • Jeong Eun Taik (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Choi Jong Bum (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine)
  • 이미경 (원광대학교 의과대학 흉부외과학교실) ;
  • 정은택 (원광대학교 의과대학 내과학교실) ;
  • 최종범 (원광대학교 의과대학 흉부외과학교실)
  • Published : 2005.12.01
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Abstract

Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

배경: 관상동맥 우회술 후 장기 생존율에 대한 우리의 보고는 많지 않다. 이 연구는 관상동맥 우회술 시작 초기에 수술 받은 환자들의 장기 생존율을 알아보았다. 대상 뜻 방법: 1990년 12월부터 1995년 12월까지 관상동맥 우회술을 받은 114예(남 79예, 여 35예, 평균연령 58.4세)를 대상으로 하였다. 대부분의 환자가 체외순환 하에 좌측 속가슴동맥과 하지 복재정맥으로 우회로술을 받았고 대동맥 차단상태에서 근위부 및 원위부 문합을 시행하였다. 결과: 평균 $135.5{\pm}17.9$개월의 추적 기간 동안 모두 37예$(32.5\%)$가 사망하였으며, 사망자 중 심장사망은 10예$(27\%)$뿐이었다 수술 후 전체 사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $95.6\%,\;85.1\%,\;71.8\%,\;57.9\%$였고, 심장사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $97.4\%,\;94.5\%,\;92.1\%,\;81.3\%$였으며, 장기 생존율에 대한 예상인자로는 성별 및 연령이었다 수술 후 관상동맥 조영술 및 중재술의 예상인자는 수술 전의 고혈압, 당뇨병, 고지혈증 등이었다. 결론: 초기의 관상동맥 우회술 후 장기생존율은 다른 보고와 비슷하였으며, 여성에서 장기생존율이 우수하였고 수술 전 고지혈증을 가진 환자에서 수술 후 관상동맥 중재술이 더 많았다.

Keywords

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