Coronary artery bypass grafting in dialysis patients

Mammary steal: a case report in bypass grafting in a hemodialysis patient

“…The use of the internal mammary artery as a conduit in dialysis dependant patients has been reported [1] though there have been case reports of mammary steal [2,3]. We report another such case in an era of growing use of this conduit.…”

“…Nakayama et al[1] reported 51 cases of CABG in End stage renal disease with 44 patients receiving IMA grafts.They have reported good results with the use of IMA grafts with only 3 patients having angina of which 2 patients V. B. Pai (*) : S. Kolvekar…”

Safety of perioperative hemodialysis and continuous hemodiafiltration for dialysis patients with cardiac surgery

“…This trend has been attributed to the improvements in operative techniques and perioperative management, resulting in favorable surgical and long-term results. 1,[7][8][9] To obtain favorable surgical outcomes, special attention during the perioperative period is required to address the ongoing problems of fl uid and electrolyte balance, the maintenance of proper hemodynamics, perioperative bleeding diathesis, and the timing and route of perioperative dialysis. In particular, proper maintenance of the serum potassium level is one of the most indispensable means to prevent life-threatening hyperkalemia that may be caused by the administration of high-volume, highpotassium cardioplegia solution for proper myocardial BUN, blood urea nitrogen; BW, body weight; pre-op., preoperative; post-op., postoperative *P < 0.0001 compared with pre-op.…”

“…To evade these obstacles, several reports have suggested the use of intraoperative hemofi ltration during CPB. 1,2,14,15 However, considering the fact that alteration of serum electrolytes using the hemofi ltration method depends on the volume of ultrafi ltrate, and the composition and amount of fl uid replacement, IHD with hemofi ltration on CPB may theoretically be more effi cient in the management of fl uid overload, hyperkalemia, and uremia than intraoperative hemofi ltration alone. 6 Our study demonstrates a signifi cant benefi t in the prevention or attenuation of intraoperative hyperkalemia and minimization of intraoperative fl uid gain.…”

“…Several studies have demonstrated various strategies, which include the use of intraoperative hemodialysis (IHD) and intraoperative hemofi ltration, producing favorable surgical outcomes. [1][2][3][4][5][6] However, there are few reports that evaluate the effects of the routine use of postoperative continuous hemodialysis (CHDF) combined with IHD on fl uid and electrolyte managements, morbidity, and mortality.…”