| Theme | Diagnosis and treatment for coronary artery disease and valvular heart disease in dialysis patients | |
|---|---|---|
| Title | Longterm outcomes for dialysis patients with chronic renal failure undergoing coronary artery bypass grafting | |
| Publish Date | 2014/07 | |
| Author | Mitsumasa Hata | Department of Cardiovascular Surgery, Nihon University Hospital |
| [ Summary ] | Chronic kidney disease (CKD) is an independent risk factor for mortality related to coronary artery bypass grafting (CABG). We assessed longterm outcomes for dialysis patients undergoing CABG. In the last 10 years, 107 dialysis patients (males 77, average age 69.3 ±9.0 years old) underwent CABG. Conventional on-pump CABG was employed for all patients and emergency operations were required in 45 patients (42.1 %). The average number of grafts, aortic cross clamp times (ACCT), and cardiopulmonary duration (CPBD) were 3.08±0.97, 38.4±26.6 min, and 105.5±38.9 min, respectively. The incidence of post-operative stroke, mediastinitis, and leg wound infection was 1.9 ％, 1.9 %, and 4.7 %, respectively. In hospital mortality was observed in three patients (2.8 %). Three patients required percutaneous coronary intervention (PCI) and two patients had redo-CABG in later phases. Furthermore, five patients underwent aortic valve replacement (AVR) in later phases. Seventeen patients died during follow-up periods (heart failure 5, pneumonia 5, stroke 4, cerebral hemorrhage 2, gastric cancer 1). Major adverse cardiovascular and cerebrovascular event (MACCE) free rates were 81.6 % at 5 years and 58.9 % at 10 years. Actuarial survival rates were 88.8 % at 5 years and 62.8 % at 10 years. CABG for dialysis patients produced good results. However, many patients suffered from cerebrovascular complications in later stages. Strict lifestyle improvement is essential to prevent atherosclerotic events in CKD patients. |
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