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Related Experiment Videos

Does off-pump coronary artery bypass grafting beneficially affect renal function?

Mitsugu Ogawa1, Hitoshi Yaku, Kiyoshi Doi

  • 1Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. m-ogawa@koto.kpu-m.ac.jp

ANZ Journal of Surgery
|August 4, 2005
PubMed
Summary

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Off-pump coronary artery bypass grafting (CABG) shows better renal protection compared to on-pump CABG. However, patients with left ventricular dysfunction or undergoing multivessel grafting require close renal monitoring even with off-pump procedures.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Innovation

Background:

  • Off-pump coronary artery bypass grafting (CABG) is suggested to improve renal function, but evidence requires further confirmation.
  • Assessing the impact of off-pump CABG on renal function is crucial for surgical decision-making.

Purpose of the Study:

  • To evaluate the effects of off-pump CABG on renal function.
  • To identify predictors of postoperative renal impairment in patients undergoing off-pump CABG.

Main Methods:

  • Retrospective study of 451 patients undergoing isolated CABG (1999-2003).
  • Comparison of perioperative serum creatinine levels and creatinine ratios between off-pump (n=300) and on-pump (n=151) CABG groups.
  • Logistic regression analysis to identify predictors of renal impairment.

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Main Results:

  • Renal impairment occurred in 12.7% of the off-pump group versus 18.5% of the on-pump group (P=0.1).
  • The creatinine ratio was significantly lower in the off-pump group (1.2 ± 0.4) compared to the on-pump group (1.4 ± 0.7, P=0.003).
  • Strongest predictors for renal impairment in off-pump CABG were left ventricular dysfunction (OR 10.8) and multivessel grafting (OR 4.3).

Conclusions:

  • Off-pump CABG offers superior renal protection compared to on-pump CABG.
  • Close perioperative renal monitoring is essential for patients with left ventricular dysfunction or those undergoing multivessel grafting, even with off-pump CABG.