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Thorac Cardiovasc Surg 2007; 55(2): 84-88
DOI: 10.1055/s-2006-955877
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Coronary Surgery in Dialysis-Dependent Patients with End-Stage Renal Failure with and without Extracorporeal Circulation

S. Tugtekin1 , U. Kappert1 , K. Jarny1 , M. Knaut1 , R. Cichon1 , K. Alexiou1 , K. Matschke1
  • 1Cardiac Surgery, Heart Center Dresden, Dresden, Germany
Further Information

Publication History

received May 2, 2006

Publication Date:
21 March 2007 (online)

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Abstract

Coronary artery bypass grafting (CABG) in dialysis-dependent patients with end-stage renal failure (ESRF) has become the standard treatment for CAD in this patient group, but is still considered as a risk procedure due to the increased mortality and morbidity. The avoidance of extracorporeal circulation in dialysis-dependent patients seems to be an attractive alternative. This retrospective study analyzed and compared our experience with CABG surgery with and without extracorporeal circulation in dialysis-dependent patients with ESRF. We analyzed the clinical results of isolated CABG in 73 dialysis-dependent patients with ESRF with and without the use of extracorporeal circulation. The on-pump group consisted of 43 patients (7 female and 36 male, 65 ± 7.3 years) and the off-pump group included 30 patients (4 female and 26 male, 67 ± 7.2 years). Demographic and preoperative data were comparable in both groups. Overall hospital mortality rate was 4.2 % (n = 3), two patients (4.6 %) in the on-pump group and one patient (3.3 %) in the off-pump group died due to noncardiac reasons. Morbidity was comparable in both groups. The mean number of grafts was 3.1 ± 0.9 in the on-pump group and 2.9 ± 0.8 in the off-pump group. During follow-up, 13 patients (30.2 %) in the on-pump group died, nine of these patients (69.2 %) due to cardiac reasons; eight patients (26.7 %) in the off-pump group died, mostly due to cardiac reasons (n = 5, 62.5 %). CABG can be performed in patients with dialysis-dependent ESRF with good clinical results and low morbidity with two different surgical approaches. Midterm results are still affected by cardiac events.

Key words

cardiovascular surgery - heart disease - coronary bypass surgery

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MD Sems Tugtekin

Cardiac Surgery
Heart Center Dresden

Fetscherstraße 76

01307 Dresden

Germany

Phone: + 49 35 14 50 17 90

Fax: + 49 35 14 50 18 02

Email: malte8554@yahoo.de