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Off-pump coronary artery bypass grafting in patients with renal dysfunction

Minoru Tabata1, Shuichiro Takanashi, Toshihiro Fukui

  • 1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan. mtab-tky@umin.ac.jp

The Annals of Thoracic Surgery
|November 25, 2004
PubMed

Insights

Renal dysfunction did not impact early outcomes in off-pump coronary artery bypass grafting. This study found comparable morbidity and mortality between patients with and without renal dysfunction undergoing the procedure.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Renal dysfunction increases risks after coronary artery bypass grafting.
  • Off-pump coronary artery bypass grafting (OPCAB) may reduce risks in patients with renal dysfunction.
  • The specific impact of renal dysfunction on OPCAB outcomes remains unclear.

Purpose of the Study:

  • To evaluate the effect of renal dysfunction on early outcomes in patients undergoing OPCAB.
  • To compare morbidity and mortality between patients with and without renal dysfunction during OPCAB.

Main Methods:

  • Retrospective review of 402 patients undergoing OPCAB.
  • Comparison of 68 patients with chronic renal dysfunction (Group A) versus 334 patients with normal renal function (Group B).
  • Multivariable analysis to identify predictors of short-term survival.

Main Results:

  • Higher blood transfusion rates in Group A (57.4%) vs. Group B (25.7%).
  • Similar in-hospital mortality: 1.5% in Group A vs. 1.2% in Group B.
  • Unstable angina, low ejection fraction, peripheral vascular disease, and redo surgery identified as risk factors for poor early outcomes.

Conclusions:

  • Early outcomes of OPCAB are comparable for patients with and without renal dysfunction.
  • Renal dysfunction is not a predictor of poor early outcomes after OPCAB.
  • OPCAB may be a safe option for patients with renal dysfunction.
Abstract

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