ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The results of conventional coronary artery bypass and beating-heart coronary artery bypass grafting in patients with hemodialysis-dependent end-stage renal failure
Burçin Abud, Ufuk Yetkin, Yüksel Beşir, Orhan Gökalp, Engin Tulukoğlu, Tayfun Göktoğan, Cengiz Özbek, Ali Gürbüz
İzmir Atatürk Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İzmir
Background: Cardiovascular disease remains the most frequent cause of death in patients with end-stage renal disease (ESRD). This study was designed to compare the perioperative and short-term results of conventional coronary artery bypass surgery (CABS) and off-pump CABS in hemodialysis-dependent ESRD patients with coronary artery disease (CAD).

Methods: Twenty-one hemodialysis-dependent ESRD patients underwent CABS for CAD. The off-pump group consisted of 11 patients (8 males, 3 females; mean age 60±11 years; range 45 to 76 years), and the on-pump group consisted of 10 patients (6 males, 4 females; mean age 62±10 years; range 42 to 74 years). The two groups were compared with respect to preoperative, perioperative, and postoperative data.

Results: The two groups did not differ with respect to demographic characteristics, preoperative risk factors, and laboratory findings (p>0.05). The mean number of anastomoses was 1.7±0.7 in the off-pump group compared to 2.1±0.7 in the on-pump group (p>0.05). The only significant perioperative difference was the operation time, which was shorter in the off-pump group (175±17 min vs 277±56 min; p<0.001). Postoperative drainage and length of intubation time were similar in the two groups, whereas the off-pump group exhibited significantly lower amount of transfusion (p<0.001), shorter intensive care unit stay (p=0.020) and hospitalization (p=0.002). Postoperative morbidity was seen in five patients, including atrial fibrillation in one patient in each group. Early mortality occurred in one patient in the on-pump group.

Conclusion: Both methods of CABS can be employed with low morbidity and mortality rates in hemodialysis-dependent ESRD patients with CAD. However, off-pump CABS can be preferred in appropriate patients due to reduced transfusion need and shorter intensive care unit and hospital stays.

Keywords : Cardiopulmonary bypass/adverse effects; coronary artery bypass, off-pump; kidney failure, chronic/complications.
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