Coronary artery bypass graft surgery in dialysis patient

Sawada, Yoshihide; Morimoto, Tomoshige; Matsuyama, Nanritsu; Kinugasa, Seiji; Hasegawa, Shigeto; Kondo, Keiichiro; Kishida, H; Sasaki, Satoshi

doi:10.1007/bf03217859

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…Coronary artery bypass grafting (CABG) for a patient with end‐stage renal disease (ESRD) was first reported in 1974 (1). Since then, numerous case reports and series of results have been published (2–31)(Appendix 1). In 1988, Opsahl et al reported that CABG effectively decreased cardiac related deaths in ESRD patients with significant coronary stenosis (24).…”

Section: Previously Reported Results Of Coronary Artery Bypass (Cabg)mentioning

confidence: 99%

Coronary Artery Bypass Grafting for Hemodialysis‐ Dependent Patients

et al. 2001

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Patients with end-stage renal disease carry a risk of coronary atherosclerosis. This study was performed to evaluate the perioperative and remote data of coronary artery bypass grafting (CABG) in hemodialysis dependent patients. We retrospectively analyzed the results of isolated CABG performed at Shin-Tokyo Hospital between June 1, 1993 and May 31, 2000. Preoperative, perioperative, and follow-up data of the patients on hemodialysis (Group HD, n = 37) were collected and compared with those of control patients (Group C, n = 1,639). Group HD consisted of 26 males and 11 females with a mean age of 59.9 +/- 8.1 years, and the mean number of bypasses was 2.5 +/- 1.1. Group HD had a longer postoperative intubation time, ICU stay, and hospital stay than Group C. The postoperative major complication rate in Group HD (18.9%) was not significantly different from that in Group C (11.3%). However, the inhospital mortality rate in Group HD (5.4%) was higher than Group C (0.6%). At the mean follow-up of 2.4 years, the actuarial 3-year survival of Groups HD and C were 90.6% and 97.6%, respectively (p < 0.001), excluding hospital mortality. The actuarial 3-year cardiac event-free rates were 84.3% in Group HD and 88.8% in Group C, showing no difference. Patients on chronic hemodialysis carry a significant risk of prolonged inhospital care and hospital death. Once successful surgical revascularization was completed, their long-term cardiac events could be controlled as effectively. The increased distant death rates was probably associated with the nature of renal disease.

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Section: Previously Reported Results Of Coronary Artery Bypass (Cabg)mentioning

confidence: 99%

Coronary Artery Bypass Grafting for Hemodialysis‐ Dependent Patients

et al. 2001

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“…LIMA‐LAD bypass has proven long‐term benefits of survival and freedom from postoperative cardiac events (8). The use of the LIMA for hemodialysis patients was first reported in 1980 (9), and since then the frequency of its use has gradually increased (Table 5)(10–30). In 1990, Blakeman et al reported a series of IMA grafting in patients with ESRD and demonstrated that the use of IMA did not alter sternal wound complications (11).…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

et al. 2002

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Patients with both end-stage renal disease and diabetes mellitus carry an increased risk of coronary atherosclerosis. This study was performed to evaluate the perioperative and remote outcome of diabetic nephropathy patients on hemodialysis undergoing coronary artery bypass grafting (CABG). We retrospectively analyzed the results of CABG performed between September 1, 1993 and August 31, 2001. Preoperative, perioperative, and follow-up data of patients with hemodialysis primarily due to diabetic nephropathy (Group D, n = 31, 22 males and 9 females with a mean age of 60.1 +/- 6.6) were collected and compared to patients with hemodialysis primarily due to nondiabetic nephropathy (group N, n = 21, 17 males and 4 females with a mean age of 60.9 +/- 11.2). Preoperative risk factors between the 2 groups were not significantly different. The mean number of distal anastomoses was 2.5 +/- 1.2 in Group D and 2.5 +/- 1.0 in Group N (p = not significant [NS]). All patients received at least 1 internal mammary artery graft. There was 1 in-hospital death in each group. Postoperative recovery, mortality, and morbidity were not significantly different between the two groups. At the mean follow-up of 2.7 years, the actuarial 3 year survival rate was 72.8% in Group D and 78.7% in Group N (p = NS). The actuarial 3 year cardiac event-free rate was 79.7% in Group D and 74.7% in Group N (p = NS). CABG for hemodialysis patients can be performed with acceptable risks. Diabetic nephropathy has no impact on early or remote patient outcomes among patients on hemodialysis.

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“…Results of CABG for patients on chronic HD have been reported frequently (3)(4)(5)(6)(7)(8)(9). Although the results have been improving, the mortality and morbidity were substantially high compared to those patients with normal renal function.…”

Section: Discussionmentioning

confidence: 99%

Immediate and Long-Term Results of Coronary Artery Bypass Operation in Hemodialysis Patients

Osaka¹,

Osawa²,

Miyazawa³

et al. 2001

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This study evaluated the early and late results of coronary artery bypass grafting (CABG) in patients on long-term maintenance hemodialysis (chronic HD) at Teikyo University Ichihara Hospital between January 1996 and June 2000. Thirty-six patients on chronic HD underwent CABG. There were 26 males (72%) and 10 females (28%) ranging from 41 to 81 years (mean +/- SD, 61.8 +/- 9.2 years) of age. Twenty-one patients (58%) had unstable angina, 14 (39%) stable angina, and 1 acute myocardial infarction. Eleven patients (31%) had urgent or emergency CABG. The average graft number was 2.5 +/- 0.8 (arterial graft 1.3 +/- 0.7/patient). Six patients had concomitant cardiac operations. Three patients underwent re- or a second re-CABG. Five patients underwent off-pump CABG. Principally, HD was performed during cardiopulmonary bypass and was followed by continuous hemodiafiltration in the early postoperative period. The early mortality was 11%; 25% in emergency and urgent CABG and 4% in elective CABG. In the follow-up period between 1 and 53 months (mean +/- SD 21.9 +/- 15.1 months), 4 patients died, and 9 patients developed recurrence of angina pectoris (6, occlusion of saphenous vein graft and 3, native coronary progression). Six patients had coronary intervention. The postoperative angiogram showed that all arterial grafts were patent, but the patency of the vein grafts was only 61.5%. The early results of CABG in patients on chronic HD was satisfactory. The late recurrence of angina pectoris mostly was caused by occlusion of the saphenous vein graft. In conclusion, the aggressive use of arterial grafts is crucial in CABG for patients on chronic HD.

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Coronary artery bypass graft surgery in dialysis patient

Cited by 9 publications

References 8 publications

Coronary Artery Bypass Grafting for Hemodialysis‐ Dependent Patients

Coronary Artery Bypass Grafting for Hemodialysis‐ Dependent Patients

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

Immediate and Long-Term Results of Coronary Artery Bypass Operation in Hemodialysis Patients

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