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Published on: March 27, 2018
Complete surgical myocardial revascularization in patients with declined renal functions: 12-month outcomes
Ibrahim C Kaya1, Halil I Bulut2, Leilani Lopes3
1Department of Cardiovascular Surgery, Eskisehir City Health Practice and Research Centers, Saglık Bilimleri Universitesi, Eskisehir, Turkey.
Insights
Complete revascularization via coronary artery bypass grafting (CABG) is feasible and safe for patients with multi-vessel disease (MVD)-CAD and poor kidney function. This approach shows promising outcomes, warranting further investigation into optimal techniques.
Area of Science:
- Cardiology
- Cardiac Surgery
- Nephrology
Background:
- Multi-vessel disease (MVD)-coronary artery disease (CAD) often presents challenges in patients with declining renal function.
- Optimal revascularization strategies for this specific high-risk population remain incompletely understood.
- Coronary artery bypass grafting (CABG) is a common treatment, but its effectiveness in renally impaired patients requires evaluation.
Purpose of the Study:
- To assess the feasibility and effectiveness of complete revascularization using CABG.
- To evaluate outcomes in patients with MVD-CAD and compromised renal function.
- To address the knowledge gap concerning treatment strategies and survival in this cohort.
Main Methods:
- Retrospective observational study design.
- Inclusion of 58 patients undergoing on-pump CABG for complete myocardial revascularization between 2020 and 2022.
- Statistical analysis using Kaplan-Meier curves and the log-rank test for overall survival.
Main Results:
- The cohort (mean age 60.7) had high comorbidity rates: hypertension (50.0%), diabetes (50.0%), and anemia (41.4%).
- Perioperative outcomes included 5.2% low cardiac output syndrome, 53.5% transfusion rates, and 3.4% in-hospital mortality.
- At 12-month follow-up, cardiac mortality was 5.2% and all-cause mortality was 6.9%, with no need for renal replacement therapy or redo revascularization.
Conclusions:
- Complete revascularization via CABG is a safe and feasible option for patients with MVD-CAD and declining renal function.
- The study suggests potential benefits of this approach in a high-risk population.
- Further research is recommended to optimize revascularization techniques for improved outcomes in this patient group.
Introduction:
This retrospective observational study aimed to evaluate the feasibility and effectiveness of complete revascularization coronary artery bypass grafting (CABG) in patients with multi-vessel disease (MVD)-CAD and declined renal functions, addressing the knowledge gap regarding optimal treatment strategies and outcomes in this specific patient population.
Methods:
Between 2020 and 2022, a total of 58 patients underwent on-pump coronary artery bypass grafting surgery for complete myocardial revascularization in this study. To assess overall survival, Kaplan-Meier with the log-rank test was conducted for statistical analysis.
Results:
The mean age of cohort was 60.7. The findings showed a high prevalence of medical conditions such as hypertension (50.0%), diabetes (50.0%), and anaemia (41.4%) among the participants. Intraoperatively, low cardiac output syndrome was reported in 5.2% of cases, while perioperative outcomes indicated a need for transfusions in 53.5% of cases and an in-hospital mortality rate of 3.4%. At the 12-month follow-up, no redo revascularization or renal replacement therapy was required, but cardiac mortality was 5.2% and all-cause mortality was 6.9%.
Conclusions:
The study concluded that complete revascularization is safe for these patients and highlights the potential benefits, emphasizing the need for further research in optimizing revascularization techniques for this population.
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