Does myocardial revascularization with multiple arterial grafts improve the prognosis of dialysis patients?
In the present study it was examined whether myocardial revascularization with multiple arterial grafts improves the prognosis of dialysis patients. The 20 subjects underwent coronary artery bypass grafting over 2 vessels (extra-corporeal circulation in 11 patients, off-pump bypass in 9 patients) and were divided into 2 groups according the number of arterial grafts. Group A consisted of 9 patients in whom more than 2 arterial grafts were used and Group B, 11 patients requiring 1 internal thoracic artery and additional saphenous vein grafts. The surgical procedure was examined, as well as the short-term and long-term results of both groups. There were no differences in the profiles of the 2 groups. The mean arterial graft number in group A was 2.2+/-0.6 and 1.0+/-0.0 in group B. There was neither mediastinitis nor brain complication in either group. There were no operative deaths in group A and 1 in group B. The 55-month actuarial survival rate including all deaths, and estimated by cardiac deaths, was, respectively, 0.53+/-0.21 and 0.80+/-0.18 in group A and 0.42+/-0.21 and 0.53+/-0.23 in group B. The survival rate estimated by cardiac death in group A was better, but there was not a significant difference. Myocardial revascularization with multiple arterial grafts for dialysis patients had good short-term results without increased operative risk and may improve the long-term results related to cardiac death. However, there was no significant difference in survival including all deaths because of the numerous non-cardiac deaths.
Tanaka
Hiroyuki
H
Department of Thoracic Cardiovascular Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan. h.tanaka@showa-university-fujigaoka.gr.jp
Narisawa
Takashi
T
Mori
Takanobu
T
Masuda
Mikio
M
Kishi
Daizirou
D
D000368:Aged; D000714:Anastomosis, Surgical; D001161:Arteriosclerosis / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods* / Q000401:mortality* / Q000592:standards; D011379:Prognosis; D006435:Renal Dialysis; D016019:Survival Analysis; D013895:Thoracic Arteries / Q000637:transplantation*; D014182:Transplantation, Autologous