Espinoza F, Barragán R, Fernández de la Reguera G, Magaña S, Gabbai F, Herrera-Acosta J
Arch Inst Cardiol Mex. 1987 Jan-Feb;57(1):45-50.
Coronary heart disease is the main cause of mortality among uremic patients on chronic hemodialysis (CHD) and is the determinant of the outcome in these cases after renal transplantation, especially in diabetics. In this study we report our experience with two uremic diabetics on CHD with severe coronary artery lesions in whom aortocoronary bypass was performed before renal transplantation. The outcome in the two patients, after 30 and 55 months respectively indicates successful results. We discuss the necessity to perform coronariography in all the high risk patients on CHD, such as diabetics and elderly before planning renal transplantation and achieve aortocoronary bypass surgery in those with severe coronary disease. The technics and difficulties of the surgery in uremics are also analized.
冠心病是慢性血液透析（CHD）尿毒症患者死亡的主要原因，也是这些患者肾移植后预后的决定因素，尤其是糖尿病患者。在本研究中，我们报告了两例患有严重冠状动脉病变的冠心病尿毒症糖尿病患者在肾移植前进行主动脉冠状动脉搭桥术的经验。两名患者分别在30个月和55个月后的结果显示手术成功。我们讨论了在计划肾移植前，对所有冠心病高危患者（如糖尿病患者和老年人）进行冠状动脉造影的必要性，并对那些患有严重冠状动脉疾病的患者进行主动脉冠状动脉搭桥手术。同时还分析了尿毒症患者手术的技术和困难。
