Coronary artery bypass grafting in hemodialysis-dependent patients: Analysis of Japan Adult Cardiovascular Surgery Database

Takashi Yamauchi, Hiroaki Miyata, Taichi Sakaguchi, Shigeru Miyagawa, Yasushi Yoshikawa, Koji Takeda, Noboru Motomura, Hiroyuki Tsukihara, Yoshiki Sawa

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Abstract

Background: Perioperative risk during coronary artery bypass grafting (CABG) is reportedly high in patients with chronic renal disease. We aimed to determine postoperative mortality and morbidity and identify the perioperative risk factors of mortality during CABG in hemodialysis (HD)-dependent patients. Methods and Results: From the Japan Adult Cardiovascular Surgery Database, we compared 1,300 HD-dependent chronic renal failure patients with 18,387 non-HD patients who all underwent isolated CABG between January 2005 and December 2008. The operative mortality and mortality, including major morbidity, was 4.8% vs. 1.4% and 23.1% vs. 13.7% in the HD and non-HD groups, respectively. Preoperative predictors of operative mortality included age, chronic obstructive pulmonary disease, peripheral arterial disease, congestive heart failure, arrhythmia, preoperative inotropic agent requirement, New York Heart Association class IV, urgent or emergency operation, poor left ventricular function, aortic valve regurgitation (>2), and mitral valve regurgitation (>3). Postoperative predictors of operative mortality included stroke, infection, prolonged ventilation, pneumonia, heart block, and gastrointestinal complications. Conclusions: Compared with non-HD patients, CABG in HD patients was associated with high mortality and morbidity rates. An appropriate surgical strategy and careful perioperative assessment and management for prevention of respiratory and gastrointestinal complications might contribute to improved clinical outcomes after CABG in these patients.

Original languageEnglish
Pages (from-to)1115-1120
Number of pages6
JournalCirculation Journal
Volume76
Issue number5
DOIs
Publication statusPublished - 2012 Apr 30

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Keywords

  • Coronary artery bypass grafting
  • Hemodialysis
  • Risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yamauchi, T., Miyata, H., Sakaguchi, T., Miyagawa, S., Yoshikawa, Y., Takeda, K., Motomura, N., Tsukihara, H., & Sawa, Y. (2012). Coronary artery bypass grafting in hemodialysis-dependent patients: Analysis of Japan Adult Cardiovascular Surgery Database. Circulation Journal, 76(5), 1115-1120. https://doi.org/10.1253/circj.CJ-11-1146