title: On-Pump versus Off-pump Myocardial Revascularization in Patients with Renal Insufficiency: Early and Mid-term Results.
abstract: BACKGROUND
  Myocardial revascularization in patients with renal insufficiency is challenging to the cardiac surgeon, irrespective of utilizing extracorporeal circulation. This study aimed to compare the number of bypass grafts and the mid-term results and to evaluate independent survival predictors in patients with renal insufficiency undergoing on-pump or off-pump myocardial revascularization.
  
  
  METHODS
  We retrospectively analyzed the data of 103 patients with renal insufficiency, who had isolated myocardial revascularization between January 1999 and January 2009. The patients were divided into two groups, the on-pump group and the off-pump group.
  
  
  RESULTS
  The off-pump group received a significantly greater number of distal arterial grafts than the on-pump group. However, the mean number of total grafts, the degree of complete revascularization, and survival rate of the patients were not significantly different between the two groups. Multivariate analysis showed the independent predictors for reduced mid-term survival were the number of total grafts and postoperative periodic renal replacement therapy. Off-pump myocardial revascularization does not decrease the number of bypass grafts or influence on the mid-term results for patients with renal insufficiency, compared to on-pump myocardial revascularization.
  
  
  CONCLUSIONS
  Myocardial revascularization with a large number of total grafts has a beneficial effect on survival in patients with renal insufficiency, irrespective of utilizing extracorporeal bypass.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea.
authors.forename: Hwan Wook
authors.initials: HW
authors.lastname: Kim
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Hyung Gon
authors.initials: HG
authors.lastname: Je
authors.forename: Soo Hwan
authors.initials: SH
authors.lastname: Choi
authors.forename: Keon Hyon
authors.initials: KH
authors.lastname: Jo
authors.forename: Hyun
authors.initials: H
authors.lastname: Song