Cardiopulmoitary bypass procedures in dialysis patients

Long-Term Outcome of Percutaneous Transluminal Coronary Angioplasty and Coronary Artery Bypass Grafting in Patients With End-Stage Renal Disease

“…19 The incidence of complication for ESRD patients is also high at 20-50% compared with that in non-ESRD patients. 15,17,18,20 In the present study, the incidence of in-hospital death in the CABG group was 15%, which was higher than the rate for patients not receiving dialysis, and the incidence of postoperative complications was also high at 30%. In Mitsui Memorial Hospital, the graft patency free of significant stenosis of under 75% in non-ESRD patients was 92% 19 and the graft patency in the present study was lower compared with that reported incidence.…”

“…[14][15][16][17] In-hospital mortality was reportedly around 10%, 17 although in one study it reached 20%. 18 This rate is obviously higher than that of non-ESRD patients, which is usually 2-3%, and a recent report gives 1%.…”

Treatment of coronary artery disease in hemodialysis patients: PTCA vs. stent

“…Since 1974, over 150 patients have been reported in the literature to receive coronary bypass surgery. In a large review of hemodialysis patients who underwent CABG, the authors found that the mortality rate was 8%-9%, several-fold higher than the 1%-3% mortality rate found in nondialysis patients when excluding major comorbidities such as chronic obstructive pulmonary disease (COPD), left ventricular dysfunction, and severe peripheral vascular disease (PVD) [16]. Aside from the higher perioperative mortality rates, hemodialysis patients also have longer intensive care unit stay periods, ventilator time, and a greater length of required hospitalization.…”

“…Approximately one-third of these deaths are attributable to myocardial infarction, with a large portion of the remaining expiring from sudden cardiac death or progressive left ventricular failure. Studies of coronary bypass surgery in hemodialysis patients have revealed an acceptable but increased risk of perioperative morbidity and an overall mortality rate of 8%-9% [2]. However, no data has yet been shown to improve survival [3].…”

Cardiovascular disease in dialysis patients: Double trouble

“…At 5 years after revascularization, event-free survival was seen in 12% of patients in the PTCA group, but in 53% of patients in the CABG group. Surgical mortality rates of 9% to 10%, such as those previously reported by Ko et al [18], are a limitation of the surgical approach.…”