CORONARY-ARTERY BYPASS GRAFT-SURGERY IN DIALYSIS PATIENTS

Objective-To examine the short term results and long term survival of patients on long term dialysis undergoing coronary artery bypass graft surgery. Methods-A retrospective analysis of 19 patients on establish ed dialysis who underwent coronary revascularisation between 1983 and 1995; 14 patients (73%) had class IV angina and five (25%) had unstabl e angina requiring heparin and nitrate infusions before surgery. Resul ts-The 30 day mortality was 5%. Follow up was completed in the remaini ng 18 patients. The mean follow up time was 34 months (range eight to 61). During the follow up period four patients died of cardiac causes. The actuarial survival at one, two, and three years was 87%, 78%, and 59%, respectively. The overall functional status was significantly im proved compared to preoperative levels, with a mean Karnofsky score of 76% (p < 0.01) at three years. Conclusions-Coronary artery bypass gra ft surgery can be performed with increased but acceptable morbidity an d mortality in chronic dialysis patients. It results in considerable i mprovement in symptoms and functional status. However, long term survi val is limited and this requires further investigation.