Immediate and long-term results of coronary revascularization in patients undergoing chronic hemodialysis

Objective: To evaluate morbidity and long-term survival in end stage renal disease (ESRD) patients, undergoing coronary artery bypass graft surgery. M ethods: We identified 22 such patients who underwent bypass grafting betwee n 1987 and 1997. Symptomatic status of angina was rated using the classific ation of the Canadian Cardiovascular Society (CCS) and the functional statu s, was assessed using the Karnofsky scoring system. The patients were hemod ialyzed the day before surgery and 24-48 h after surgery. Results: Two pati ents operated on for acute myocardial infarction died after 4 days. Follow- up was completed in the remaining 20 patients (the mean follow-up time was 25 +/- 15 months). The survival rates at 1, 2 and 3 years was 84.5%, 74% an d 59%, respectively. The symptoms diminished and the functional status was significantly improved. Conclusion: We conclude that elective coronary arte ry bypass in dialysis patients can be performed with acceptable morbidity a nd mortality. We advocate early surgical treatment; However, long-term surv ival is limited and this requires further investigation. (C) 1999 Elsevier Science B.V. All rights reserved.