Coronary artery bypass grafting for dialysis patients

Abstract

Objective: To assess the efficacy and safety of cardiopulmonary bypass during coronary artery bypass grafting (CABG) in dialysis patients.Methods and results: Sixty four isolated CABG patients who underwent on cardiopulmonary bypass and whose intraoperative body weight gains were accurately measured were studied retrospectively. The mean intraoperative body weight gain was 2.61±0.9 kg/m² in the study group and 1.06±0.6 kg/m² in controls, i.e) 100 patients selected at random from CABG patients during the same period using cardiopulmonary bypass without chronic renal faulure, showing a statistically significant difference. Complete revascularization was successful in 98% of patients. Postoperative nonlethal complications involved brain infarction in 1 patient (1.7%), reintubation in 1 (1.7%), and paralytic ileus in 2 (3.4%). All were successfully extubated within 24 hours of surgery, and no sternal wound complications were found. Hospital mortality was 6.3% (4/64). Actuarial survival rates at 3, 5 and 8 years including all deaths were 90%, 70% and 56%, and estimated by cardiac deaths were 95%, 90%, and 90% respectively. Cardiac event free rates were 90%, 73% and 61% at 3, 5 and 8 years after CABG.Conclusions: In CABG for dialysis patients, the use of cardiopulmonary bypass demonstrates significant merits, and may expect long-term survival with minimal postoperative complications.