Off-pump technique reduces surgical mortality after elective coronary artery bypass grafting in patients with preoperative renal failure

The Journal of Thoracic and Cardiovascular Surgery
Chikara UekiJapan Cardiovascular Surgery Database

Abstract

Most randomized controlled trials of off-pump versus on-pump coronary artery bypass grafting (CABG) have included limited numbers of patients with preoperative renal failure. This study was performed to evaluate the association between the clinical benefit of the off-pump technique and chronic kidney disease stage. We analyzed 38,051 patients with chronic kidney disease who underwent primary nonemergent isolated CABG from 2013 to 2015 as reported in the Japan Cardiovascular Surgery Database-Adult section. These patients were stratified into 4 categories according to their estimated glomerular filtration rate (eGFR) of 60 to 90, 30 to 59, and <30 mL/min/1.73 m2, and hemodialysis-dependent. The clinical outcomes were compared between patients undergoing off-pump and on-pump CABG in each stratum using inverse probability of treatment weighting. In total, 23,634 (62.1%) patients were intended for off-pump CABG. In patients with mildly reduced renal function (eGFR 60-89 mL/min/1.73 m2), there was no significant risk reduction effect of off-pump CABG for surgical mortality. Conversely, in patients with moderate or severe renal disease (eGFR <60 mL/min/1.73 m2), off-pump CABG was associated with a significantly lower incidence of surg...Continue Reading

Citations

Apr 1, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Torsten DoenstGloria Faerber
Feb 9, 2019·Journal of Cardiac Surgery·Valentino BiancoIbrahim Sultan
Aug 23, 2019·The Journal of Thoracic and Cardiovascular Surgery·Abduzhappar GaipovCsaba P Kovesdy
Jul 6, 2021·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Sudipto Bhattacharya
Aug 16, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mateo Marin-CuartasPiroze M Davierwala
Apr 7, 2019·The Journal of Thoracic and Cardiovascular Surgery·Takashi KuniharaUNKNOWN Japan Cardiovascular Surgery Database
May 11, 2020·The Journal of Thoracic and Cardiovascular Surgery·Torsten DoenstUNKNOWN Working Group and Surgical Treatment for IsChemic Heart failure Trial Investigators

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