Off-pump and on-pump coronary revascularization in preoperatively compensated renal failure patients

Hüseyin Ali Tünel,

doi:10.5606/tgkdc.dergisi.2011.002

Hüseyin Ali Tünel¹, Öner Gülcan¹, İsa Coşkun¹, Orhan Saim Demirtürk¹, Rıza Türköz²

¹Başkent Üniversitesi Adana Uygulama ve Araştırma Merkezi, Kalp ve Damar Cerrahisi Anabilim Dalı, Adana
²Başkent Üniversitesi İstanbul Uygulama ve Araştırma Merkezi, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul

DOI : 10.5606/tgkdc.dergisi.2011.002

Background: In this retrospective study, renal functions and postoperative results in patients with compensated renal failure (CRF) undergoing coronary revascularization using cardiopulmonary bypass (CPB) or beating heart (BH) methods have been evaluated.

Methods: Fifty-eight patients with CRF who underwent coronary revascularization between January 2001 and May 2008 were included in the study. The patients were divided into two groups according to the method of revascularization; the patients operated with CPB (group 1 n=45, mean age 64±9.2 years) and the patients operated with BH (group 2; n=13, mean age 66.5±7.9 years). The two groups were compared with respect to demographic characteristics, preoperative, postoperative and discharge day renal functions, hemodialysis requirements and early and mid-term results.

Results: The demographic characteristics were similar in both groups. No statistically significant differences were found in the patients with respect to postoperative diuretic use, inotropes, need of intraaortic balloon pump, hemodialysis, requirement for revision due to bleeding, postoperative complications or in-hospital and late mortalities (p<0.05). There was no statistically significant differences between the groups in relation to postoperative and discharge day BUN and creatinine values. The mean follow-up time was 44.4±30.4 months. The requirement of permanent hemodialysis in the follow-up period was significantly higher in group 2 (p<0.05). There was no early mortality in group 2 whereas there were three early mortalities in group 1. Late mortality was observed in one patient in group 1 and in two patients in group 2.

Conclusion: Use of either CPB or BH did not make any difference on the early postoperative renal function in compensated renal failure patients. Although the low number of our patients is a limiting factor, we think that preoperative renal function is not a decisive factor in choosing CPB or BH technique.

Keywords : Cardiopulmonary bypass; compensated renal failure; coronary bypass

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