Coronary revascularization in patients maintained on chronic hemodialysis

Thirty-two thousand patients are presently maintained in chronic dialysis programs. Cardiovascular complications have been shown to be responsible for 50 to 65% of the deaths in such patients. Despite this and the increasingly frequent use of coronary bypsss surgery in the general population, only two patients have previously been reported to have successfully undergone coronary bypass surgery while maintained on chronic hemodialysis. This reports two additional such patients who successfully underwent coronary revascularization without difficulty. Pertinent details of preoperative, intraoperative, and postoperative management are outlined for these patients and the other 13 chronic dialysis patients who have had cardiopulmonary bypass for other reasons. With careful planning, coronary revascularization can be successfully carried out in this group of patients with minimally increased operative risk.