Long-term results of bilateral internal thoracic artery grafting in dialysis patients.
BACKGROUND
We evaluated the perioperative and long-term results of bilateral internal thoracic artery grafting in dialysis patients.


METHODS
One hundred one consecutive patients on chronic dialysis who underwent isolated coronary artery bypass grafting were retrospectively compared according to the surgical technique, bilateral internal thoracic artery (BITA) grafting (n = 76) or single internal thoracic artery (SITA) grafting (n = 25).


RESULTS
Hospital mortality was 5.3% in the BITA group and 8.0% in the SITA group (p = not significant). The incidence of mediastinitis was not different (7.9% in the BITA group and 8.0% in the SITA group). The median duration of follow-up was 3.1 years (range, 0.1 to 10.9). Survival and freedom from cardiac mortality were not different between the two groups, but the BITA group had a trend toward better results. Freedom from cardiac events (including cardiac-related death, myocardial infarction, percutaneous coronary intervention, redo coronary artery bypass grafting, and congestive heart failure) was superior in the BITA group (p = 0.03). Calcification of the ascending aorta, peripheral vascular disease, insulin-dependent diabetes mellitis, and age were the independent risk factors of late death.


CONCLUSIONS
Perioperative results of BITA grafting in dialysis patients were not different from the results of SITA grafting. However, the long-term results of BITA grafting in dialysis patients were better than the results of SITA grafting. Overall, our results support the continued use of BITA grafting in dialysis patients.
Kai
Masashi
M
Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyusyu City, Fukuoka, Japan.
Okabayashi
Hitoshi
H
Hanyu
Michiya
M
Soga
Yoshiharu
Y
Nomoto
Takuya
T
Nakano
Jota
J
Matsuo
Takehiko
T
Umehara
Eitaro
E
Kawato
Masahide
M
D000368:Aged; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016896:Treatment Outcome