ニイナミ　ヒロシ   NIINAMI Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
言語種別	英語
発表タイトル	Impact Of Inhaled Nitric Oxide In High-Risk Patients Underwent Coronary Artery Bypass Grafting
会議名	5th International Coronary Congress
学会区分	国際学会及び海外の学会
発表形式	口頭
発表者・共同発表者	◎SHINTOMI Shizuya, ICHIHARA Yuki, MORITA Kozo, IKEDA Masahiro, SAWA Shintaro, HINO Atomu, NIINAMI Hiroshi
発表年月日	2019/12/06
開催地 （都市, 国名）	New York, USA
概要	*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.