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Off-pump Coronary Artery Bypass Grafting in patients on chronic hemodialysis

S Osaka1, H Ohsawa, M Miyazawa

  • 1Cardiovascular Center, Teikyo University Ichihara Hospital, Japan. shinichi-osaka@pop06.odn.ne.jp

Journal of Cardiac Surgery
|February 9, 2002
PubMed

Insights

Off-pump coronary artery bypass grafting (CABG) is feasible in patients undergoing chronic hemodialysis (HD). This study demonstrates successful outcomes using in situ arterial grafts in a small cohort of HD patients.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Vascular Grafting

Background:

  • Off-pump coronary artery bypass grafting (CABG) is increasingly utilized but lacks extensive reporting in patients on chronic hemodialysis (HD).
  • This study presents the surgical details and outcomes of CABG in patients with end-stage renal disease requiring chronic HD.

Purpose of the Study:

  • To evaluate the safety and efficacy of off-pump CABG in patients on chronic hemodialysis.
  • To describe the surgical techniques and graft choices for this specific patient population.

Main Methods:

  • A retrospective review of 5 patients on chronic HD who underwent off-pump CABG between January 1998 and December 1999.
  • Patients presented with unstable angina pectoris; indications included suitable coronary anatomy and high risk associated with cardiopulmonary bypass.
  • Surgical approaches included median sternotomy and left anterior short thoracotomy, with a mean of 2.0 grafts per patient, primarily utilizing in situ arterial grafts.

Main Results:

  • No operative deaths or complications were observed in the study cohort.
  • Postoperative angiography confirmed 90% graft patency before hospital discharge.
  • Mean follow-up of 17.2 months showed no recurrence of angina or cardiac symptoms.

Conclusions:

  • Off-pump CABG utilizing in situ arterial grafts is a viable option for patients on chronic hemodialysis.
  • Successful outcomes are contingent upon suitable coronary artery anatomy for grafting.
Abstract

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