Early Results of Coronary Artery Bypass Grafting in Patients on Dialysis

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ID: 314164
2026
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Abstract
Background: While coronary artery bypass grafting CABG (Coronary Artery Bypass Grafting) is the preferred revascularization strategy for multi-vessel disease in dialysis patients, perioperative risk remains prohibitive. The relative prognostic importance of renal versus cardiac parameters is poorly defined, and the optimal surgical conduit strategy is debated. This study aimed to evaluate the early mortality and morbidity of dialysis-dependent patients undergoing isolated CABG and to identify independent predictors of early survival. Methods: We prospectively studied 100 dialysis-dependent patients undergoing isolated CABG under a standardised multidisciplinary protocol conducted between January 2022 and March 2023 in the National Heart Institute, Cairo, Egypt. We analysed early (30-day) outcomes and performed regression modelling to identify predictors of mortality. Results: We observed an early mortality rate of 7%. Contrary to conventional cardiac surgical risk models, in this exploratory multivariate model, we identified elevated baseline serum creatinin (odds ratio, 3.46; P = 0.029) as a potential independent predictor of death; left ventricular function was not predictive. The cohort exhibited a distinct morbidity profile, with high rates of bleeding (11%) and infection (3%). Notably, the left internal mammary artery was utilized in only 6% of cases, with saphenous vein grafts serving as the primary conduit for revascularization. Conclusions: This study challenges the primacy of cardiac metrics in risk-stratifying dialysis patients for CABG, establishing preoperative renal function as the dominant prognostic factor. Our findings justify a paradigm shift in preoperative optimization and support a patientcentered surgical approach that may selectively eschew standard arterial grafting to safeguard critical dialysis access. This tailored strategy yielded mortality rates favorable to contemporary benchmarks.
Reference Key
mohamed2026early Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ahmed Abdalla Mohamed, Ahmed Mohamed Elshemy, Wael Shahat Nekhila
Journal Yemen Journal of Medicine
Year 2026
DOI
10.63475/yjm.v5i1.0272
URL
https://yemenjmed.com/abstract?article_id=348
Keywords Keywords not found

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