Effects of Cardiopulmonary Bypass on Dialysis-dependent Patients

Background

End-stage renal disease is considered an independent risk factor for early and late survival after coronary artery bypass grafting.

Methods

We retrospectively analysed patients with dialysis-dependent renal insufficiency who had undergone coronary artery bypass surgery between 2010 and 2017. Patients who were operated with the assistance of cardiopulmonary bypass (ONCAB) were in group 1 and those operated with off-pump coronary artery bypass surgery (OPCAB) were in group 2. We compared peri-operative morbidity and mortality rates and short-term results of the two groups.

Results

There were 74 patients in group 1 and 36 in group 2. Blood transfusion requirement, drainage, need for intraaortic balloon pump and duration of stay in intensive care unit was statistically significantly higher in group 1 (p < 0.05). Also, postoperative creatine kinase (CK) and creatine kinasemuscle/ brain (CKMB) values were statistically significantly higher in group 1 (p = 0.003).

Conclusion

Coronary artery bypass grafting under ONCAB was a potential risk for morbidity and mortality in patients with end-stage renal disease. Performing OPCAB surgery may improve postoperative outcomes and should be kept in mind as a surgical option.