Coronary-Artery Surgery in Patients with End-Stage Renal Disease

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Abstract
From 1975-1979 coronary arteriography was performed on 15 patients with end-stage renal failure and clinical evidence of severe ischemic heart disease. One patient died after the procedure of severe pump failure. Ten patients subsequently received coronary artery bypass grafts, and 2 of these patients also received mitral-valve replacement. One patient, a diabetic died of sepsis after surgery. Of the 9 surviving patients, 8 including the 2 patients who had undergone mitral-valve replacement, are markedly improved as a result of surgery. These patients can evidently undergo angiography and coronary-artery bypass surgery at an increased but acceptable risk, provided dialysis is done before and after cardiac catheterization and surgery to control extracellular volume overload and hyperkalemia. The operation benefits patients with end-stage renal failure and severe ischemic heart disease by relieving angina and improving their level of activity. It is unclear whether survival is improved for these patients.

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