Does off-pump coronary artery bypass reduce the incidence of clinically evident renal dysfunction after multivessel myocardial revascularization?

Anesthesia and Analgesia
Nanette M SchwannAndrew S Wechsler

Abstract

In this prospective, observational trial, we determined whether off-pump coronary artery bypass (OPCAB) was associated with less postoperative renal dysfunction (RD) compared with coronary bypass surgery with cardiopulmonary bypass (CABG). All patients undergoing primary, isolated coronary surgery at our institution in the year 2000 participated. Data collected on each patient included demographics, preoperative risk factors for RD, perioperative events, and serum creatinine concentrations from date of admission until discharge or death. The criteria for RD was both a >or=50% increase from preoperative creatinine and an absolute postoperative creatinine >or=2.0 mg/dL (177 microM). Student's t-test or the Fisher's exact test was used to compare groups. Stepwise multiple logistic regression identified determinants of RD; P < 0.05 significant. The CABG group (n = 119) differed from the OPCAB group (n = 220) with respect to age (64 +/- 13 versus 67 +/- 10 yr, P = 0.0074) and number of distal grafts (median 4 versus 3, P = 0.0003). Type of operation did not associate with the presence of postoperative RD: 18 (8.2%) of 220 OPCAB patients versus 12 (10%) of 119 CABG patients (P = 0.55). Our data suggest that choice of operative techni...Continue Reading

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Citations

Apr 5, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Parwis MassoudyStefan Herget-Rosenthal
May 19, 2012·Journal of the American Society of Nephrology : JASN·Lakhmir S ChawlaJ Matthew Brennan
Aug 25, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Mercedes Garcia-AlvarezRinaldo Bellomo
Mar 1, 2012·Kidney International Supplements
Mar 1, 2012·Kidney International Supplements
Aug 25, 2011·Heart, Lung & Circulation·Edward A CooperMichael P Vallely
Jun 28, 2011·The Annals of Thoracic Surgery·Bryon J BoultonVinod H Thourani
May 2, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sagar U NigwekarCharuhas V Thakar
Oct 24, 2007·The Annals of Thoracic Surgery·Michele Di MauroAntonio M Calafiore
Jun 3, 2008·American Heart Journal·A Selcuk AdabagYellaprada Chandrashekhar
Dec 15, 2015·Seminars in Cardiothoracic and Vascular Anesthesia·Gary LauC David Mazer
May 31, 2014·Seminars in Cardiothoracic and Vascular Anesthesia·Stephen A EsperKenichi A Tanaka
Nov 6, 2008·Asian Cardiovascular & Thoracic Annals·Joanna S M OoiMohd Z Dimon
Jan 31, 2008·Journal of Intensive Care Medicine·Mitchell H RosnerMark D Okusa
Mar 20, 2010·European Journal of Anaesthesiology·Apoorva PrasadKanchi Muralidhar
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Mitchell H Rosner, Mark D Okusa
Nov 8, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Robert H ThieleMitchell H Rosner
Jul 1, 2007·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Mitsugu OgawaHitoshi Yaku
May 28, 2005·Anesthesia and Analgesia·Nanette M Schwann, Jay Horrow

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