Coronary Artery By-pass Surgery and Renal Transplantation

Menzoı́an, James O.; Davis, Robert C.; Idelson, Beldon A.; Mannick, John A.; Berger, Robert L.

doi:10.1097/00000658-197401000-00012

Cited by 45 publications

(15 citation statements)

References 6 publications

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“…They have relief from angina with improvement in functional status. Since the best long-term survival results, as shown by previous studies [10], are correlated to a short period of dialysis before operation, we advocate early surgical treatment because CABG in these patients is associated with acceptable perioperative mortality and morbidity. The aim of surgical intervention in ESRD patients was to reduce the incidence of cardiac-related mortality resulting from myocardial infarction and according to a report [16], long-term survival is better when the duration of maintenance dialysis is shorter and when patients are free of left ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 89%

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Immediate and long-term results of coronary revascularization in patients undergoing chronic hemodialysis

Castelli

1999

European Journal of Cardio-Thoracic Surgery

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Objective: To evaluate morbidity and long-term survival in end stage renal disease (ESRD) patients, undergoing coronary artery bypass graft surgery. Methods: We identified 22 such patients who underwent bypass grafting between 1987 and 1997. Symptomatic status of angina was rated using the classification of the Canadian Cardiovascular Society (CCS) and the functional status, was assessed using the Karnofsky scoring system. The patients were hemodialyzed the day before surgery and 24-48 h after surgery. Results: Two patients operated on for acute myocardial infarction died after 4 days. Follow-up was completed in the remaining 20 patients (the mean follow-up time was 25 ± 15 months). The survival rates at 1, 2 and 3 years was 84.5%, 74% and 59%, respectively. The symptoms diminished and the functional status was significantly improved. Conclusion: We conclude that elective coronary artery bypass in dialysis patients can be performed with acceptable morbidity and mortality. We advocate early surgical treatment. However, long-term survival is limited and this requires further investigation.

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Section: Discussionmentioning

confidence: 89%

“…The first report of CABG in a patient with ESRD, was published by Menzoian and co-workers in 1974 [10]; since then, numerous reports have documented the …”

Section: Discussionmentioning

confidence: 99%

Immediate and long-term results of coronary revascularization in patients undergoing chronic hemodialysis

Castelli

1999

European Journal of Cardio-Thoracic Surgery

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“…The first coronary artery bypass grafting (CABG) was performed in 1974 in a patient with chronic renal failure by Menzoin et al 1 Since then, many case reports and retrospective reviews on small groups of patients have been published regarding the benefit and feasibility of CABG in this patient population 2 . Some groups have shown improved survival and improved quality of life 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Importance of early dialysis for acute renal failure after an open‐heart surgery

Iyem

Tavli

Akçiçek

et al. 2009

Hemodialysis International

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Coronary artery disease is a major cause of death in patients with a renal dysfunction. Among the patients who undergo coronary artery bypass grafting, renal dysfunction is known to be a major predictor of in-hospital and out-of-hospital mortality. From 2004 to 2007, we performed elective open-heart surgeries on 2380 patients in whom there was no primary renal failure. Of those patients, only 185 in whom acute renal failure (ARF) was developed were included in the study. The patients were divided into 2 groups: a late dialysis group (n=90) and an early dialysis group (n=95). The mean age of the patients was 62.3+/-6.4 in the late dialysis group and 64.5+/-5.2 in the early dialysis group. There were 32 female and 58 male patients in the late dialysis group and 36 female and 59 male patients in the early dialysis group. Acute renal failure developed only in 185 patients out of 2380 open-heart surgery patients. The overall mortality in the 2380 open-heart surgery patients was 1.97%. Mortality among the ARF patients was 5.9%. However, there was no significant difference in hospital mortality between the 2 groups. Major complications, such as postoperative pneumonia, prolonged ventilation time, arrhythmia, the number of times postoperative hemodialysis was performed, development of chronic renal failure, time spent in the intensive care unit and the period of hospitalization, sepsis, and low cardiac output, were significantly higher in the late dialysis group. There was no difference in mortality between the 2 groups. Early dialysis for open-heart surgery patients who develop ARF postoperatively does not decrease mortality. However, it decreases morbidity, the amount of time spent in intensive care, and the period of hospitalization and thus reduces patient costs.

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“…There is also a direct correlation between death and age in the dialysis population (1). The first coronary artery bypass surgery (CABG) in a patient with chronic renal failure was carried out by Menzoin and associates (2) in 1974. Since then, many case reports and retrospective reviews in small groups of patients have been published regarding the benefit and feasibility of CABG in this patient population (3).…”

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confidence: 99%

Prophylactic Dialysis in Elderly Patients Undergoing Coronary Bypass Surgery

et al. 2007

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Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery (CABG), especially in elderly patients. In the current study, we aimed to determine the impact of prophylactic preoperative hemodialysis on operative outcome in patients with mild renal dysfunction. Between March 2002 and May 2005 a total of 64 patients, all of whom were more than 70 years of age and with preoperative creatinine levels greater than 2 mg/dL, underwent primary elective on pump coronary artery bypass surgery. The mean age was 76.3 +/- 6.4 (range 70-83). The patients were prospectively allocated into two groups. Group A was the dialysis group (31 patients) and preoperative prophylactic hemodialysis was carried out in all patients. Group B (33 patients) was taken as a control group without preoperative hemodialysis. During the present study, 10 patients died (15.6%) in the hospital. In the postoperative period mean levels of creatinine were found to be decreased in dialysis group. (2.3 +/- 0.8 mg/dL vs. 3.4 +/- 0.2 mg/, P = 0.037). The incidence of overall morbidity (such as acute renal failure, need of postoperative dialysis, low cardiac output and multiple organ failure) were also found to be decreased in dialysis group. We conclude from the present study that preoperative renal dysfunction and advanced age increase the risk of mortality and morbidity after on-pump coronary artery bypass surgery. We believe that perioperative prophylactic hemodialysis is an easy and effective method and it decreases both operative mortality and morbidity in elderly patients with renal dysfunction.

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Coronary Artery By-pass Surgery and Renal Transplantation

Cited by 45 publications

References 6 publications

Immediate and long-term results of coronary revascularization in patients undergoing chronic hemodialysis

Immediate and long-term results of coronary revascularization in patients undergoing chronic hemodialysis

Importance of early dialysis for acute renal failure after an open‐heart surgery

Prophylactic Dialysis in Elderly Patients Undergoing Coronary Bypass Surgery

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