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Coronary artery bypass grafting in patients with dialysis-dependent renal failure

Chung-Dann Kan1, Yu-Jen Yang

  • 1Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, Taiwan, Republic of China. kcd56@mail.ncku.edu.tw

Texas Heart Institute Journal
|November 26, 2004
PubMed

Insights

Coronary artery bypass grafting is a viable option for dialysis patients with end-stage renal disease, showing acceptable risks despite increased bleeding and longer hospital stays. Careful management ensures patient safety during this cardiac surgery.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Cardiovascular disease is the primary cause of mortality in end-stage renal disease (ESRD) patients requiring dialysis.
  • The aging population is increasing the number of ESRD patients needing surgical revascularization.
  • The safety of coronary artery bypass grafting (CABG) in long-term dialysis patients is a significant clinical concern.

Purpose of the Study:

  • To evaluate the safety and outcomes of coronary artery bypass grafting (CABG) in patients dependent on dialysis.
  • To compare perioperative and long-term results of CABG in dialysis-dependent patients versus non-dialysis controls.

Main Methods:

  • Retrospective review of 23 dialysis-dependent patients undergoing isolated CABG (Group D) from January 1998 to March 2003.
  • Comparison with 69 matched non-dialysis patients (Group ND) who underwent CABG in 2001.
  • Analysis of preoperative, operative, and postoperative data, including complications and mortality.

Main Results:

  • No significant differences were observed in preoperative factors, intubation time, ICU stay, major complications, or 30-day mortality between Group D and Group ND.
  • Dialysis-dependent patients exhibited a higher tendency for bleeding and experienced longer postoperative hospital stays.
  • Group D had a greater number of late deaths compared to the non-dialysis control group.

Conclusions:

  • Coronary artery bypass grafting is feasible in dialysis-dependent ESRD patients.
  • Successful outcomes require a well-prepared dialysis program and meticulous perioperative management.
  • While perioperative morbidity and mortality risks are increased, they are considered acceptable in this patient population.

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