Document Detail


Long-term survival after coronary arterial grafts in patients with end-stage renal disease.
MedLine Citation:
PMID:  20732488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bilateral internal thoracic artery (BITA) grafting is known to improve the long-term survival after coronary artery bypass grafting (CABG). However, there are few reports regarding the efficacy of BITA grafting in end-stage renal disease (ESRD) patients. This study investigates the potential benefits of BITA grafting in ESRD patients. METHODS: One hundred thirty ESRD patients dependent on chronic hemodialysis underwent isolated CABG in the Kumamoto Central Hospital from 1988 to 2009. The early results and long-term outcomes in 49 patients using BITA (BITA group) were compared with 81 patients using a single ITA (SITA group). The mean follow-up time was 5.2 +/- 3.8 years. RESULTS: The mortality rate was 4.9% for the SITA group and 4.1% for the BITA group (p = 0.8215). No differences were seen for the incidence of mediastinitis or a rethoracotomy for bleeding. The 3-year, 5-year, 7-year, and 10-year survival rates in the SITA group were 79.6%, 62.5%, 43.6%, and 22.6%, respectively. The corresponding survival rates in the BITA group were 76.0%, 61.9%, 58.8%, and 33.2%, respectively. There were no statistical differences in survival (p = 0.1636), freedom from cardiac death (p = 0.3205), or freedom from cardiac events (p = 0.4071). In ESRD patients without diabetes mellitus, BITA grafting improves the outcomes concerning cardiac events (p = 0.0143). CONCLUSIONS: After a long-term follow-up, CABG with BITA grafts showed no advantages in the long-term outcomes among ESRD patients. However, for ESRD patients without diabetes mellitus, BITA grafting may provide more promising long-term outcomes.
Authors:
Taro Nakatsu; Nobushige Tamura; Yutaka Sakakibara; Kouji Hagio; Masanosuke Ishigami
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  738-43     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Kumamoto Central Hospital, Kumamoto City, Japan. nakatsu-taro@hotmail.co.jp
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass / methods,  mortality*
Female
Humans
Kidney Failure, Chronic*
Male
Mammary Arteries / transplantation
Middle Aged
Retrospective Studies
Survival Rate
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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