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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Cardiovascular Surgery

Advisor

Dr. Nancy Reid, DHSc, PA-C, DFAAPA

Abstract

Outcomes of Coronary Artery Bypass Surgery In Patients With End Stage Renal Disease

ABSTRACT

Objective: Evaluation of postoperative outcomes from coronary artery bypass grafting (CABG) in patients with end stage renal disease (ESRD) and comparison of short and long-term outcomes for CABG vs percutaneous coronary interventions (PCI).

Methods: A literature review was conducted via PubMed with search terms CABG, chronic kidney disease (CKD), ESRD, hemodialysis, and postoperative outcomes. Article selection was based on research quality and relevance to the proposed research question.

Results: Chronic kidney disease is an independent risk factor for coronary artery disease (CAD) and contributes to the ultimate progression of CAD and requirement for revascularization. Average in hospital mortality associated with CABG in ESRD patients is approximately 10%. Long-term survival rates at 1 and 2 years post-CABG are approximately 70% and 50%, respectively. CABG confers significantly increased short-term risks when compared to PCI but has greater long-term survival advantages and decreased need for revascularization.

Conclusion: The risks associated with CABG for patients with ESRD are significantly higher than those with normal renal function. Increased morbidity and mortality are seen in patients with ESRD. CABG is recommended over PCI for long-term survival in patients with ESRD who require coronary revascularization.

Keywords: CABG, CKD, ESRD, PCI, postoperative outcomes, morbidity, mortality

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