Impact of Dialysis on Open Cardiac Surgery

Abstract

Background: Dialysis patients frequently have coronary artery disease but are regarded as high risk patients for coronary artery bypass grafting (CABG).

Methods: 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 perioperative and mid-term outcome were reviewed.

Results: 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 perioperative mortality. In mid-term follow-up (mean time: 11.8±9.5 months) the mid-term mortality rate was 20% (3 patients).

Conclusion: CABG in chronic renal dialysis patients can be accomplished with acceptable short and mid-term morbidity and mortality.