Safety and efficacy of off-pump coronary artery bypass grafting in chronic dialysis patients.
Off-pump coronary artery bypass grafting (CABG) has been recently revived, because cardiopulmonary bypass (CPB) appears to worsen the multiple organ dysfunction after conventional CABG. To evaluate the safety and efficacy of the off-pump CABG in chronic dialysis patients, we compared the perioperative morbidity and mortality between 15 dialysis patients who underwent off-pump CABG at our center over the past 8 years with that of a concurrent group of 19 patients who underwent conventional CABG. Patients were selected for off-pump CABG only when complete revascularization was technically feasible. We found that off-pump CABG is as safe and effective as conventional CABG in selected dialysis patients. It might even be beneficial, because it is associated with less hematocrit drop and blood product use, a lower catabolic rate, and fewer dialysis requirements after surgery. However, the impact of off-pump technique on the long-term clinical outcome and resource utilization in renal patients requires further investigation.
Papadimitriou
Lila J
LJ
Aretaieio University Hospital, 76 Vass. Sofias Avenue, Athens 11528, Greece.
Marathias
Katerina P
KP
Alivizatos
Petros A
PA
Michalis
Alkiviadis
A
Palatianos
George M
GM
Stavridis
George T
GT
Demesticha
Theano
T
Koussi
Theophili
T
Agroyannis
Basil
B
Vlahakos
Demetrios V
DV
D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011182:Postoperative Care; D011300:Preoperative Care; D006435:Renal Dialysis