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Minoru Tabata
Shuichiro Takanashi
Toshihiro Fukui
Tetsuya Horai
Yasuyuki Hosoda
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Ann Thorac Surg 2004;78:2044-2049
© 2004 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Off-Pump Coronary Artery Bypass Grafting in Patients With Renal Dysfunction

Minoru Tabata, MD*, Shuichiro Takanashi, MD, Toshihiro Fukui, MD, Tetsuya Horai, MD, Tomoya Uchimuro, MD, Katsukiyo Kitabayashi, MD, Yasuyuki Hosoda, MD

Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan

Accepted for publication June 11, 2004.

* Address reprint requests to Dr Tabata, Division of Cardiac Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA02446 (E-mail: mtab-tky{at}umin.ac.jp).

BACKGROUND: Renal dysfunction is a predictor of increased morbidity and mortality after coronary artery bypass grafting, whether it is dialysis-dependent or not. Several studies have shown the efficacy of off-pump technique in reducing morbidity and mortality in patients with renal dysfunction. However, the actual effect of renal dysfunction in off-pump coronary artery bypass grafting has not been well understood.

METHODS: We conducted a retrospective review of 402 consecutive patients undergoing off-pump coronary artery bypass grafting from April 2001 to June 2003. Sixty-eight patients had chronic renal dysfunction (group A); 19 patients were dialysis-dependent; 334 patients had normal renal function (group B). Operative variables, morbidity, and mortality were compared between the two groups. Furthermore, multivariable analysis was performed to identify predictors for short-term survival.

RESULTS: Preoperative characteristics were similar in the two groups. Blood transfusion rate was higher in group A than group B (57.4% and 25.7%, respectively; p < 0.001). In-hospital mortality was similar (1.5% and 1.2% in group A and B, respectively; p = 0.853). Multivariable analysis revealed that unstable angina, low ejection fraction, peripheral vascular disease and redo surgery are significant risk factors for poor early result of off-pump coronary artery bypass grafting.

CONCLUSIONS: Early outcomes of off-pump coronary artery bypass grafting in patients with renal dysfunction were comparable to those in patients with normal renal function. Renal dysfunction is not a predictor of poor early outcomes after off-pump coronary artery bypass grafting.




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T. Horai, T. Fukui, M. Tabata, and S. Takanashi
Early and mid-term results of off-pump coronary artery bypass grafting in patients with end stage renal disease: surgical outcomes after achievement of complete revascularization
Interactive CardioVascular and Thoracic Surgery, April 1, 2008; 7(2): 218 - 221.
[Abstract] [Full Text] [PDF]


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