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Coronary artery bypass grafting in dialysis patients

  • Hiroyuki Tanaka
  • Kazuhiro Suzuki
  • Takashi Narisawa
  • Toshihiko Ookura
  • Yoshito Kamio
  • Shuuiti Suzuki
  • Akihiko Kitami
  • Takashi Suzuki
  • Toshihiro Takaba
Original Article

Abstract

Objective: In dialysis patients, there are two issues to consider, water-electrolyte control and a bypass technique for a calcified aorta. We used continuous hemofiltration for water-electrolyte control and an off-pump bypass with arterial grafting for a calcified aorta.Methods: We performed coronary artery bypass grafting with extracorporeal circulation in 9 cases and without extracorporeal circulation (off-pump bypass) in 3 cases. In 6 cases, the operation was urgent, and in 6 cases the operation was elective.Results: An average of 3.2 grafts/pt, (the arterial graft: 1.3 grafts/pt) was performed in the pump cases. In the off-pump bypass cases we used arterial grafting only (1.7 grafts/pt). We had 1 early death (sudden death) and 1 hospital death (SLE encephalopathy). One late death due to cerebral bleeding occurred at 2 years later. We used continuous hemofiltration for 2 to 11 days (average 3.9 days) in the pump cases. The off-pump cases could be controlled by conventional hemodialysis.Conclusion: Continuous hemofiltration was very easily set up with less interference to the hemodynamics. Using an arterial graft with off-pump bypass, an aortic no-touch technique and water control with conventional hemodialysis were possible.

Key words

coronary artery bypass grafting off-pump bypass hemodialysis continuous hemofiltration 

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 2000

Authors and Affiliations

  • Hiroyuki Tanaka
    • 1
  • Kazuhiro Suzuki
    • 1
  • Takashi Narisawa
    • 1
  • Toshihiko Ookura
    • 1
  • Yoshito Kamio
    • 1
  • Shuuiti Suzuki
    • 1
  • Akihiko Kitami
    • 1
  • Takashi Suzuki
    • 1
  • Toshihiro Takaba
    • 1
    • 2
  1. 1.Department of Thoracic and Cardiovascular SurgeryShowa University Fujigaoka HospitalYokohamaJapan
  2. 2.1st Department of SurgeryShowa UniversityTokyoJapan

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