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Updated: Jul 10, 2026
04:36
Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
OPCAB in patients on hemodialysis
Rodrigo Milani1, Paulo Roberto Slud Brofman, José Augusto Moutinho de Souza
1Santa Casa de Misericórdia in Curitiba - PUC/PR, Curitiba, PR. rodrigo.milani@sbccv.org.br
Summary
Off-pump coronary artery bypass (OPCAB) surgery is safe and effective for chronic renal insufficiency patients on hemodialysis. This high-risk group experienced no deaths and low complication rates, demonstrating favorable hospital outcomes.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Anesthesiology
Background:
- Patients with chronic renal insufficiency on hemodialysis represent a high-risk population for myocardial revascularization.
- Traditional methods may carry increased risks for this vulnerable group.
Purpose of the Study:
- To evaluate the hospital outcomes of patients with chronic renal insufficiency undergoing hemodialysis who were treated with off-pump coronary artery bypass (OPCAB) surgery.
- To assess the safety and efficacy of OPCAB in this specific high-risk subgroup.
Main Methods:
- A cohort of 51 patients with chronic renal insufficiency on hemodialysis underwent OPCAB.
- Hemodialysis was administered the day before and the day after surgery.
- Myocardial revascularization utilized LIMA grafts with suture and suction stabilization techniques.
Main Results:
- The study analyzed 51 patients (average age 61.28 years; 58.8% female) with significant comorbidities (41.1% NYHA Class IV, 41.1% low ejection fraction).
- Mean EUROSCORE was 7.65. Patients underwent an average of 3.1 distal anastomoses.
- Mean mechanical ventilation was 3.78 hours, ICU stay was 41.9 hours, and hospital stay was 6.5 days. Complications included atrial fibrillation (17.6%) and one ischemic stroke (1.9%) with full recovery. No in-hospital mortality occurred.
Conclusions:
- Off-pump coronary artery bypass surgery appears to be a safe and effective strategy for myocardial revascularization in chronic renal insufficiency patients requiring hemodialysis.
- This approach resulted in low complication rates, no mortality, and acceptable ICU and hospital lengths of stay in this high-risk population.
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