Clinical effects of coronary artery surgical treatment in uremic dialysis patients with coronary heart disease
10.11958/20170266
- VernacularTitle:冠脉搭桥术治疗尿毒症规律透析合并冠心病患者的临床观察
- Author:
Junwu CHAI
;
Kai WANG
;
Xiangrong KONG
;
Honglei CHEN
;
Fenlong XUE
;
Weitie WANG
;
Wei ZHOU
- Keywords:
kidney failure;
chronic;
coronary disease;
extracorporeal circulation;
coronary artery bypass;
off-pump
- From:
Tianjin Medical Journal
2017;45(9):973-976
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of surgical treatment in patients with uremia and severe coronary artery disease, and reduce the perioperative risk thereof. Methods Sixteen chronic renal failure patients who were received haemodialysis and underwent coronary artery bypass grafting (CABG) during the period of February 2009 to December 2016 in Tianjin First Central Hospital were assessed in this retrospective study. Of the 16 patients, 8 patients and 6 patients were treated with off pump and on pump CABG respectively, one patient was treated with CABG and resection of ventricular aneurysm, and one patient was treated with CABG and tricuspid valve replacements. The renal function changes in preoperative and postoperative periods, 2-day and 1-week after surgery were observed. Echocardiography was used to evaluate cardiac function. The improvement of angina was recorded. Results Fourteen patients were successfully withdrawn from ventilator therapy within 24 h after surgery. The tracheal intubation was removed 65-hour after surgery in one patient. One patient died of multiple organ failure on the seventh day after surgery. The average length of ICU staying and in-hospital stay were (125.5 ± 21.6) h and (28.6 ± 7.4) days respectively. The serum creatinine (sCr) and blood urea nitrogen (BUN) were higher in two days after surgery than those before the operation (P < 0.05). Fifteen patients which followed up (the final follow-up date was February 2017) showing cardiac functionⅠ-Ⅱ, ejection fraction (EF)>0.40, and no angina occurred. Conclusion CABG is relatively safe for patients with end-stage renal disease and severe coronary artery disease. CABG can significantly eliminate angina symptoms with satisfactory clinical effect.
