Perioperative and mid-term results of coronary bypass surgery in patients undergoing chronic dialysis.
OBJECTIVE
The goal of this study was to evaluate perioperative and mid-term results of coronary artery bypass grafting (CABG) in patients with end-stage renal disease (ESRD).


METHODS
Thirty-five consecutive dialysis patients who required CABG over a 5-year period were investigated retrospectively.


RESULTS
Mean patient age was 62.5+/-11.5 years. The mean number of diseased vessels was 2.3W0.8. Off-pump CABG (OPCAB) was performed in 12 patients. The mean number of anastomoses per patient was 2.5+/-1.1. The perioperative mortality was 5.7%, and the average duration of hospitalization was 25.3+/-13.4 days. Overall 5-year survival rates were 63.7%. The cardiac-related 5-year survival rate was 89.3%, and the cardiac event-free rate was 51.7%. Multivariate analysis failed to identify any significant prognosticators for perioperative or long-term outcomes. The morbidity rate was significantly lower in patients undergoing OPCAB than in patients undergoing conventional CABG (8.3 vs. 47.8%; p=0.03). Perioperative mortality in the OPCAB group was 0%, and the average duration of hospitalization was shorter in the OPCAB group than in the conventional CABG group (19.7 days vs. 28.5 days; p=0.1).


CONCLUSIONS
In the context of coronary artery bypass surgery, OPCAB produced better outcomes than conventional CABG procedure in patients undergoing chronic dialysis. Further-more, OPCAB procedure seems to offer a greater benefit to dialysis patients than non-dialysis patients.
Ariyoshi
Tsuneo
T
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
Eishi
Kiyoyuki
K
Yamachika
Shiro
S
Hazama
Shiro
S
Takai
Hideaki
H
Odate
Tomohiro
T
Matsukuma
Seiji
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D006435:Renal Dialysis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome