Journal of Chest Surgery

  • 제38권3호
  • /
  • Pages.191-196
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  • 2005
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

관상동맥우회술 후 1년 및 5년 추적 관상동맥조영술을 이용한 문합부위의 형태학적 변화

Morphologic Follow-Up of the Anastomotic Sites Using One-year and Five-year Angiography after Coronary Artery Bypass Grafting

  • 조광리 (서울대학교 병원 흉부외과) ;
  • 김준성 (서울대학교 병원 흉부외과) ;
  • 최재성 (서울대학교 병원 흉부외과) ;
  • 채인호 (서울대학교병원 내과) ;
  • 오병희 (서울대학교병원 내과) ;
  • 이명묵 (서울대학교병원 내과) ;
  • 박영배 (서울대학교병원 내과) ;
  • 김기봉 (서울대학교 병원 흉부외과)
  • Cho Kwang Ree (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University) ;
  • Kim Jun-Sung (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University) ;
  • Choi Jae-Sung (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University) ;
  • Chae In-Ho (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Oh Byung-Hee (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee Myoung-Mook (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Park Young-Bae (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim Ki-Bong (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University)
  • 발행 : 2005.03.01
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초록

서울대학교병원 흉부외과에서 시행한 관상동맥우회술 환자에서 수술 후 1년 및 5년째에 관상동맥조영술을 시행하여 문합 부위의 형태학적 변화를 분석하였다 대상 및 방법: 1995년 1월부터 1997년 12월 사이에 관상동맥우회술만을 시행한 219예 중 수술 후 1년 및 5년째 추적 관상동맥조영술을 시행한 149예($75.3\%$) 및 115예($58.1\%$)를 대상으로 문합 부위의 변화 및 개존율을 FitzGibbon 등급을 사용하여 분석하였다. 결과: 동맥도관을 이용한 문합은 수술 후 1년 및 5년 개존율은 각각 $96.5\%$ (192/199), $93.1\%$ (134/144)로 복재정맥도관의 개존율 $82.9\%$ (224/270), $77.5\%$ (141/182)보다 유의하게 높았다(p<0.01). 동맥도관 및 복재정맥도관 각각의 개존율은 수술 후 1년 및 5년 사이에 유의하게 감소하였으나, 복재정맥도관의 경우에서는 FitzGibbon 등급 B의 비율이 1년째의 $5.2\%$에서 5년째에 $8.2\%$로 증가하여 정맥도관질환의 더 빠른 진행을 시사하였다(p<0.01). 결론: 관상동맥우회술 후 동맥도관의 개존율은 수술 후 1년 및 5년째에 모두 복재정맥의 개존율보다 우수하였다. 복재정맥도관은 동맥도관에 비해 협착 진행의 비율이 수술 후 1년에서 5년 사이에 유의하게 높았다.

We analysed the characteristics of anastomotic sites after coronary artery bypass grafting (CABG) using coronary angiographies (CAGs) performed at one and five years postoperatively in the same patient population. Material and Method: Among the 219 patients who underwent isolated CABGs between January 1995 and December 1997, follow-up coronary angiograms were performed in 149 ($75.3\%$) patients at one year and in 115 ($58.1\%$) patients at five years postoperatively. FitzGibbon grading system was used to evaluate the anastomotic sites. Result: The patency rates of arterial grafts at one- and five-year were $96.5\%$ (192/199) and $93.1\%$ (134/144), which were higher than those of saphenous vein grafts (SVGs) ($82.9\%$ (224/270) and $77.5\%$ (141/182), respectively) (p=0.01). Although there were significant decreases in the patency rates between one- and five-year CAGs of both arterial and venous grafts, the proportion of FitzGibbon grade B among the SVGs was increased from $5.2\%$ (one-year) to $8.2\%$ (five-year), suggesting the progression of vein graft disease (p < 0.01). Conclusion: The patency rate of the arterial graft was higher than that of SVG in both one- and five-year CAGs. The attrition rate of saphenous vein graft was higher than arterial grafts.

키워드

참고문헌

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