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Redo off-pump coronary artery bypass grafting for high risk hemodialysis patients

Shin-ichi Osaka1, Hajime Ohsawa, Akihiro Nabuchi

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

Journal of Cardiac Surgery
|March 13, 2003
PubMed

Insights

Redo off-pump coronary artery bypass grafting (OPCAB) is a viable option for patients on hemodialysis with complex aortic calcification. This technique, using specific arterial and venous grafts, offers a safe and effective solution for revascularization.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Minimally Invasive Cardiac Surgery

Background:

  • Increasing prevalence of reoperative coronary artery bypass grafting (CABG) in patients undergoing long-term hemodialysis.
  • Off-pump CABG (OPCAB) as a potential strategy to mitigate risks in redo CABG procedures.

Observation:

  • Two patients with chronic hemodialysis and calcified ascending aorta underwent redo double coronary OPCAB.
  • Surgical approach involved median sternotomy with specific bypass strategies for LAD and PDA.
  • Left internal thoracic artery (LITA) used for LAD bypass; composite graft (RITA/SV) for PDA.

Findings:

  • Both patients experienced uncomplicated, rapid recovery post-surgery.
  • Postoperative angiography confirmed graft patency in one patient.
  • Patients remained angina-free at 6 and 3 months follow-up.

Implications:

  • Redo OPCAB for LAD and PDA is feasible with minimal dissection via median sternotomy.
  • Successful utilization of LITA and composite RITA/SV grafts in this challenging patient cohort.
  • Demonstrates a safe and effective surgical option for complex redo CABG in hemodialysis patients.
Abstract

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