Off-pump coronary artery bypass grafting in patients with end-stage renal disease on hemodialysis.
BACKGROUND
Coronary artery bypass grafting (CABG) for hemodialysis patients is high risk compared with other patient groups. The aim of this study was to analyze the potential benefits of off-pump CABG for hemodialysis patients.


METHODS
From April 1994 through December 2000, 26 hemodialysis patients underwent CABG. The off-pump group consisted of 15 patients operated on without a pump and the on-pump group consisted of 11 patients operated on with a pump.


RESULTS
There was no difference between the two groups with regard to mean age, mean number of diseased vessels and mean number of anastomoses per patient. No patient died in either group during hospitalization. The postoperative complication rate was low in both groups. The postoperative ventilation time was shorter in the off-pump group (8.5 vs 26.1 hours, p < 0.001, respectively [off-pump group vs on-pump group]). The length of ICU stay was shorter in the off-pump group (1.7 vs 3.5 days, p = 0.01, respectively [off-pump group vs on-pump group]). The medial cost was lower in the off-pump group (26,200.80 dollars versus 44,024.10 dollars p = 0.0001 respectively [off-pump group vs on-pump group]).


CONCLUSIONS
Off-pump CABG provided excellent less-invasive cardiac surgical results for dialysis patients.
Tashiro
Tadashi
T
Department of Cardiovascular Surgery, University of Fukuoka School of Medicine, Fukuoka, Japan. tashirot@fukuoka-u.ac.jp
Nakamura
Katsuhiko
K
Morishige
Noritsugu
N
Iwakuma
Akio
A
Tachikawa
Yutaka
Y
Shibano
Ryuichi
R
Iwahashi
Hidehiko
H
Zaitsu
Ryuzi
R
Hayashida
Yoshio
Y
Koga
Satoshi
S
Takeuchi
Kazuma
K
Kimura
Michio
M
D000368:Aged; D003196:Computer Graphics; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate