Coronary artery bypass grafting in hemodialysis-dependent patients: analysis of Japan Adult Cardiovascular Surgery Database

DOI Web Site PubMed 被引用文献14件 参考文献45件
  • Yamauchi Takashi
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Miyata Hiroaki
    Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo
  • Sakaguchi Taichi
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Miyagawa Shigeru
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Yoshikawa Yasushi
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Takeda Koji
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Motomura Noboru
    Department of Cardiac Surgery, Faculty of Medicine, Graduate School of Medicine, University of Tokyo
  • Tsukihara Hiroyuki
    Department of Cardiac Surgery, Faculty of Medicine, Graduate School of Medicine, University of Tokyo
  • Sawa Yoshiki
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine

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タイトル別名
  • Coronary Artery Bypass Grafting in Hemodialysis-Dependent Patients
  • – Analysis of Japan Adult Cardiovascular Surgery Database –

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Background: Perioperative risk during coronary artery bypass grafting (CABG) is reportedly high in patients with chronic renal disease. We aimed to determine postoperative mortality and morbidity and identify the perioperative risk factors of mortality during CABG in hemodialysis (HD)-dependent patients. Methods and Results: From the Japan Adult Cardiovascular Surgery Database, we compared 1,300 HD-dependent chronic renal failure patients with 18,387 non-HD patients who all underwent isolated CABG between January 2005 and December 2008. The operative mortality and mortality, including major morbidity, was 4.8% vs. 1.4% and 23.1% vs. 13.7% in the HD and non-HD groups, respectively. Preoperative predictors of operative mortality included age, chronic obstructive pulmonary disease, peripheral arterial disease, congestive heart failure, arrhythmia, preoperative inotropic agent requirement, New York Heart Association class IV, urgent or emergency operation, poor left ventricular function, aortic valve regurgitation (>2), and mitral valve regurgitation (>3). Postoperative predictors of operative mortality included stroke, infection, prolonged ventilation, pneumonia, heart block, and gastrointestinal complications. Conclusions: Compared with non-HD patients, CABG in HD patients was associated with high mortality and morbidity rates. An appropriate surgical strategy and careful perioperative assessment and management for prevention of respiratory and gastrointestinal complications might contribute to improved clinical outcomes after CABG in these patients. (Circ J 2012; 76: 1115-1120)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 76 (5), 1115-1120, 2012

    一般社団法人 日本循環器学会

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