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[Cardiosurgical therapy of coronary heart disease in terminal kidney insufficiency]
Insights
Aortocoronary bypass grafting for coronary heart disease in patients with end-stage renal disease offers significant symptom improvement and a low perioperative mortality rate, enhancing long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Transplantation Medicine
Background:
- End-stage renal disease (ESRD) presents significant challenges for patients with coronary heart disease (CHD).
- Surgical interventions for CHD in ESRD patients require careful consideration of risks and benefits.
Purpose of the Study:
- To evaluate the complications and long-term results of aortocoronary bypass grafting (ACBG) in patients with ESRD.
- To assess the safety and efficacy of ACBG in this high-risk population.
Main Methods:
- Retrospective analysis of 65 patients with CHD on dialysis who underwent ACBG between 1982 and 1992.
- Patients received haemofiltration during the bypass operation; coronary angiography confirmed triple-vessel disease in 62%.
Main Results:
- Perioperative mortality rate was 4.6%.
- 95% of survivors were symptom-free at 6 months postoperatively.
- Long-term survival rates were 71% at 3 years and 55% at 5 years.
Conclusions:
- ACBG can be performed with acceptable perioperative mortality in ESRD patients with CHD.
- The procedure significantly improves symptoms and offers favorable long-term survival in this population.
Objective:
To determine retrospectively the complications and long-term results of aortocoronary bypass grafting in patients with end-stage renal disease.
Patients And Methods:
65 patients with coronary heart disease (CHD) and on dialysis (54 men, 11 women; average age 56.9 +/- 8.1 years) underwent aortocoronary bypass grafting between 1982 and 1992. Mean duration of dialysis (haemo- or peritoneal) was 41.1 +/- 45.0 (1-215) months. All patients had had haemofiltration treatment in conjunction with the bypass operation.
Results:
Coronary angiography demonstrated triple-vessel disease in 40 patients (62%). Average number of bypasses was 2.8 per patient. Perioperative death rate was 4.6%. 95% of survivors were free of symptoms 6 months postoperatively. Long-term survival rate was 71% after 3 years and 55% after 5 years.
Conclusion:
Aortocoronary bypass grafting for CHD in patients with end-stage renal disease can be performed with a low perioperative mortality rate and significantly improves symptoms.