Coronary bypass procedures in patients with renal artery stenosis.
OBJECTIVE
We present our experience on patients with renal artery stenosis undergoing myocardial revascularization procedures.


METHODS
Eighteen patients with varying degrees of renal artery stenosis were operated for coronary artery bypass grafting between 1996 and 2003. The overall incidence was 0.15%. There were nine male and nine female patients with a mean age of 62 +/- 8.2 (40-72 years). Four had bilateral and eight had significant unilateral (>50%) renal artery stenoses. Preoperatively, three patients had renal arterial intervention (stenting), and one patient was on hemodialysis. The mean preoperative creatinine value was 2.6 +/- 2.7 mg/dL (range 0.7 to 9.3). The patients were followed medically: two patients underwent off-pump coronary bypass grafting and the others were operated on-pump.


RESULTS
There was only one mortality and two patients required hemodialysis postoperatively. The postoperative mean creatinine values were 3.4 +/- 4.9 mg/dL (range 1.0 to 12.5). No electrolyte imbalances were noted except that one case revealed a transient metabolic acidosis. Five patients required inotropic support with dopamine and two needed diuretic infusions. Only five patients demonstrated a refractory hyper tensive period postoperatively.


CONCLUSIONS
The concomitant correction of renal artery stenosis with CABG is usually not necessary, but the principles for renovascular diseases must be kept in mind and individually oriented strategies must be planned.
Kosuyolu Heart and Research Hospital, Istanbul, Turkey. drvedat2002@yahoo.com
Vedat
V
Erentug
Nilgün
N
Bozbuga
Adil
A
Polat
Altug
A
Tuncer
Basar
B
Sareyyupoglu
Kaan
K
Kirali
Esat
E
Akinci
Cevat
C
Yakut
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012078:Renal Artery Obstruction / Q000150:complications / Q000503:physiopathology*; D018570:Risk Assessment