Impact of Dialysis on Open Cardiac Surgery

ABSTRACT

Dialysis patients frequently have coronary artery disease but are regarded as high risk patients for coronary artery bypass grafting [CABG]. Between February 2002 and September 2006, seventeen dialysis-dependent patients underwent isolated CABG at our center. CABG was performed under cardiopulmonary bypass [CPB] for all the patients. All cases had been maintained on hemodialysis and the duration of preoperative hemodialysis ranged from 6 to 24 months [mean 13.4 +/- 6.4]. The patients' characteristics, clinical and operative data as well as preoperative and mid-term outcome were reviewed. All patients were men with a mean age of 53 +/- 8.4 years. Mean preoperative ejection fraction was 45.5% +/- 10.4% [range 25 to 60%]. One internal mammary graft was used in 16 [94.1%] patients. Cardiopulmonary bypass and aortic cross-clamp times were 71.3 +/- 18.7 and 40.5 +/- 8.3 minutes respectively. The more frequent complication was prolonged mechanical ventilation in 2 [11.7%], there was no preoperative mortality. In mid-term follow-up [mean time 11.8 +/- 9.5 months] the mid-term mortality rate was 20% [3 patients]. CABG in chronic renal dialysis patients can be accomplished with acceptable short and mid-term morbidity and mortality