OPCAB in patients on hemodialysis.
OBJECTIVE
To analyze the hospital outcomes of patients, with chronic renal insufficiency in the hemodialysis, submitted to OPCAB.


METHODS
Fifty-one patients with chronic renal insufficiency were submitted to OPCAB. Hemodialysis was performed on the day before and the day after the operation. Myocardial revascularization was performed using LIMA's suture and suction stabilization.


RESULTS
Fifty-one patients, with an average of 61.28+/-11.09 years, were analyzed. Thirty patients (58.8%) were female. The predominant functional class was IV in 21 (41.1%) of the patients. The left ventricle ejection fraction was dire in 21 (41.1%) patients. The mean EUROSCORE of this series was 7.65+/-3.83 and the mean number of distal anastomosis was 3.1+/-0.78 per patient. The average time of mechanical ventilation was 3.78+/-4.35 hours and the mean ICU stay was 41.9+/-13.8 hours, while the average hospitalization was 6.5+/-1.31 days. In respect to complications, nine (17.6%) of the patients developed atrial fibrilation, and one (1.9%) patient presented with a case of ischemic stroke but had a good recovery during hospitalization. There were no deaths in this series.


CONCLUSIONS
Chronic renal patients submitted to hemodialysis were always a high risk population for myocardial revascularization. In this series, the absence of extracorporeal circulation appeared to be safe and efficient in this special subgroup of patients. The operations were performed with low indices of complications, absence of deaths and relatively low stays in the ICU and in hospital.
Milani
Rodrigo
R
Santa Casa de Misericórdia in Curitiba - PUC/PR, Curitiba, PR. rodrigo.milani@sbccv.org.br
Brofman
Paulo Roberto Slud
PR
Souza
José Augusto Moutinho de
JA
Barboza
Laura
L
Guimarães
Maximiliano Ricardo
MR
Barbosa
Alexandre
A
Varela
Alexandre Manoel
AM
Ravagnelli
Marcel Rogers
MR
Silva
Francisco Maia da
FM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D003327:Coronary Disease / Q000209:etiology; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome