Original articleAdult cardiacImpact of Preoperative Renal Dysfunction in Patients Undergoing Off-Pump Versus On-Pump Coronary Artery Bypass
Section snippets
Study Subjects and Sample
Patients were identified by querying the institutional Society of Thoracic Surgery Adult Cardiac Database for primary CABG patients at Emory University between January 1, 1996 and May 5, 2009. Patients undergoing a concomitant cardiac surgical procedure were excluded, while emergent and salvage patients were included. This study was approved by the Emory University Institutional Review Board and waived the need for individual patient consent.
Surgical Technique
All patients underwent a single primary CABG
Results
There were 14,199 patients undergoing isolated CABG in our institution over a 13-year period: 8,086 (56.9%) of these patients underwent OPCAB, while 6,113 (43.1%) underwent ONCAB. Preoperative RD was common, comprising 75.3% (n = 10,696 of 14,199) of the study population. Using the MDRD formula to estimate eGFR, and subgrouped according to National Kidney Disease guidelines: normal eGFR was noted in 24.7% (n = 3,503 of 14,199); mild RD [51.0%, n = 7,236 of 14,199); moderate RD [20.1%, n = 2,860
Comment
The current study represents a large single-center cohort of patients with both short-term and long-term all-cause survival, comparing outcomes of CABG patients with varying levels of preoperative renal dysfunction. The present study builds on our previous findings noting the impact of renal dysfunction on short-term outcomes of 483,914 patients undergoing CABG from the STS National Adult Cardiac Database by further evaluating OPCAB patients [22]. We found that preoperative RD, defined as eGFR
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2022, Practical Cardiology: Principles and ApproachesImpact of Preoperative Occult Renal Dysfunction on Early and Late Outcomes After Off-Pump Coronary Artery Bypass
2021, Heart Lung and CirculationCitation Excerpt :It was also found that the incidence of preoperative RD was quite high in OPCABG patients. Bryon et al. reported a similar incidence of RD (75.3%) in 14,199 CABG patients [19]. Renal dysfunction has negative effects on postoperative complications and mortality after cardiac surgery [27–30].
Off-pump technique reduces surgical mortality after elective coronary artery bypass grafting in patients with preoperative renal failure
2018, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Finally, because of the lack of long-term data in the present study, our analysis of the clinical benefit of OPCAB is limited to short-term outcomes. Boulton et al25 reported that among patients with moderate to severe renal disease, long-term survival was worse in those who underwent OPCAB than ONCAB. The association between OPCAB and long-term survival in patients with preoperative renal dysfunction requires further study.
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