Erentug Vedat, Akinci Esat, Kirali Kaan, Kayalar Nihan, Kaynak Evren, Ogus Halide, Mansuroglu Denyan, Bozbuga Nilgun Ulusoy, Yakut Cevat
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, 81020 Istanbul, Turkey.
Tex Heart Inst J. 2004;31(2):153-6.
Patients who have dialysis-dependent renal disease frequently present with coronary artery disease but are considered at high risk for coronary artery bypass grafting. From 1 September 2000 through 31 August 2003, we performed complete off-pump coronary revascularization in 6 patients who had end-stage dialysis-dependent renal failure, and we prospectively studied the perioperative and early postoperative results. The effect of off-pump coronary artery bypass grafting on mortality, morbidity, postoperative complications, and transfusion requirements in this group of patients was investigated. No perioperative deaths or ischemic cardiac events were observed after off-pump coronary artery bypass grafting. In all patients, anginal symptoms were relieved during the postoperative period. The mean duration of follow-up was 172 +/- 12.4 months. Patients with dialysis-dependent chronic renal failure who present with coronary artery disease should be thoroughly evaluated preoperatively for risk factors and coexistent severe diseases. We believe that in patients with end-stage dialysis-dependent chronic renal failure, off-pump coronary revascularization is a good alternative.
患有依赖透析的肾病患者常伴有冠状动脉疾病，但被认为进行冠状动脉搭桥手术的风险很高。从2000年9月1日至2003年8月31日，我们对6例终末期依赖透析的肾衰竭患者进行了完全非体外循环冠状动脉血运重建，并对围手术期和术后早期结果进行了前瞻性研究。研究了非体外循环冠状动脉搭桥术对该组患者死亡率、发病率、术后并发症及输血需求的影响。非体外循环冠状动脉搭桥术后未观察到围手术期死亡或缺血性心脏事件。所有患者术后心绞痛症状均得到缓解。平均随访时间为172±12.4个月。患有依赖透析的慢性肾衰竭且伴有冠状动脉疾病的患者术前应全面评估危险因素和并存的严重疾病。我们认为，对于终末期依赖透析的慢性肾衰竭患者，非体外循环冠状动脉血运重建是一种不错的选择。
