新冨　静矢    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Language	English
Title	Impact Of Inhaled Nitric Oxide In High-Risk Patients Underwent Coronary Artery Bypass Grafting
Conference	5th International Coronary Congress
Conference Type	International society and overseas society
Presentation Type	Speech
Publisher and common publisher	◎SHINTOMI Shizuya, ICHIHARA Yuki, MORITA Kozo, IKEDA Masahiro, SAWA Shintaro, HINO Atomu, NIINAMI Hiroshi
Date	2019/12/06
Venue (city and name of the country)	New York, USA
Summary	*Special Rapid Fire Abstract Session OBJECTIVE: Inhaled nitric oxide (iNO) therapy may decrease a pulmonary vascular resistance and improve the gas exchange in patients with pulmonary hypertension, however, the efficacy of iNO in high-risk patients underwent coronary artery bypass grafting (CABG) has not been demonstrated. Aim of this study is to assess the early outcome of iNO in patients underwent CABG in our single-center. METHODS: We enrolled seventeen patients underwent CABG requiring iNO therapy perioperatively between July 2017 and August 2019. The difference between pre- and post-cardiac findings with the iNO therapy were evaluated. RESULTS: The median age of the patients was 69.7 ± 11.1 (52 - 87) years. As for pre-operative cardiac findings by an echocardiography, LVDd, LVDs and LVEF were 60.5 ± 6.2 (43 - 74) mm, 46.2 ± 8.5 (23 - 66) mm and 38.2 ± 7.2 (22 - 63) %, respectively. The mean level of BNP was 1046 ± 1011 (24 - 3557) pg/mL. Eleven patients (65 %) were underwent off-pump CABG. The mean of distal graft anastomoses was 3.4 ± 1.8 (1 - 6) sites. Five patients (29 %) initiated iNO intraoperatively. The result of Swan-Ganz data revealed as follows (pre- vs post-iNO therapy, respectively); systolic pulmonary artery pressure was 40.4 ± 6.2 vs 32.4 ± 6.0 % (p<0.01), CI was 2.2 ± 0.4 vs 2.5 ± 0.5 mm (p<0.05) and SvO2 was 67.9 ± 9.1 vs 71.4 ± 9.6 mm (p=0.39). Duration of iNO and mechanical ventilation were 78.5 ± 82.7 (7 - 332) hours and 149.3 ± 154.1 (12 - 582) hours. The 30-day survival rate was 85.6 % and thirteen patients (76 %) were discharged. CONCLUSIONS: iNO therapy significantly reduced systolic pulmonary artery pressure and increased CI in patients underwent CABG. Physiological effects of perioperative iNO on the cardiovascular system may contribute the early survival even in the high-risk CABG patients.