Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study

Background: Coronary artery bypass surgery using cardiopulmonary bypass [CPB] carries the risk of renal impairment, which cannot be attributed to a single factor. This study compared the off-pump technique with the on-pump technique on kidney function in ischemic heart disease patients. Aim of the...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Khalid Abdelsamad, Mohamed Shaffik Hassan, Mohamed Eldesouky Sharaa, Ismail Nasr Elsokkary
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	coronary artery on pump coronary revascularization renal insufficiency dialysis Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/17b7e5b9c9924620b5685e0725bb11cf
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:17b7e5b9c9924620b5685e0725bb11cf
record_format	dspace
spelling	oai:doaj.org-article:17b7e5b9c9924620b5685e0725bb11cf2021-12-02T10:46:43ZOff-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study2636-41742682-378010.21608/ijma.2020.43214.1173https://doaj.org/article/17b7e5b9c9924620b5685e0725bb11cf2021-01-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_120303_cf284d4edd39e625771521a7c0b27164.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Coronary artery bypass surgery using cardiopulmonary bypass [CPB] carries the risk of renal impairment, which cannot be attributed to a single factor. This study compared the off-pump technique with the on-pump technique on kidney function in ischemic heart disease patients. Aim of the work: The study aimed to compare off-pump with on-pump technique on kidney and heart functions in patients with renal impairment with no need for dialysis but with impaired Ejection fraction [EF]. Patients and methods: This prospective non-randomized study included 60 patients who presented with symptoms of ischemic heart disease and subsequently underwent myocardial revascularization with preoperative serum creatinine levels between 1.6 to 2.5 mg/dl and EF below 45%. Patients were as following: Group A patients [on-pump]: included those who underwent surgery on cardiopulmonary bypass. Group B patients [off-pump]: included those who underwent off-pump surgery. Both groups were compared in terms of renal impairment markers and needed for dialysis and early postoperative outcome. Results: Renal impairment needs management by dialysis was developed in nine patients [30%] in the pump group [group I] and two patients [7.67%] in the off-pump group, with a significant difference. Group [I] showed a significant increase of transfused blood, blood urea nitrogen, serum creatinine, acute kidney injury [13 patients], reopening for bleeding, postoperative renal impairment, need for renal dialysis, total intensive care unit stay, and the total duration of hospital admission. However, it had a significant reduction in hemoglobin and creatinine clearance. Conclusion: Off-pump coronary revascularization offers a better kidney function preservation and has a decreased risk for kidney dysfunction in patients with renal impairment without dialysis compared with coronary revascularization with cardiopulmonary bypass.Khalid AbdelsamadMohamed Shaffik HassanMohamed Eldesouky SharaaIsmail Nasr ElsokkaryAl-Azhar University, Faculty of Medicine (Damietta)articlecoronary arteryon pumpcoronary revascularizationrenal insufficiencydialysisMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 1, Pp 976-983 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary artery on pump coronary revascularization renal insufficiency dialysis Medicine (General) R5-920
spellingShingle	coronary artery on pump coronary revascularization renal insufficiency dialysis Medicine (General) R5-920 Khalid Abdelsamad Mohamed Shaffik Hassan Mohamed Eldesouky Sharaa Ismail Nasr Elsokkary Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
description	Background: Coronary artery bypass surgery using cardiopulmonary bypass [CPB] carries the risk of renal impairment, which cannot be attributed to a single factor. This study compared the off-pump technique with the on-pump technique on kidney function in ischemic heart disease patients. Aim of the work: The study aimed to compare off-pump with on-pump technique on kidney and heart functions in patients with renal impairment with no need for dialysis but with impaired Ejection fraction [EF]. Patients and methods: This prospective non-randomized study included 60 patients who presented with symptoms of ischemic heart disease and subsequently underwent myocardial revascularization with preoperative serum creatinine levels between 1.6 to 2.5 mg/dl and EF below 45%. Patients were as following: Group A patients [on-pump]: included those who underwent surgery on cardiopulmonary bypass. Group B patients [off-pump]: included those who underwent off-pump surgery. Both groups were compared in terms of renal impairment markers and needed for dialysis and early postoperative outcome. Results: Renal impairment needs management by dialysis was developed in nine patients [30%] in the pump group [group I] and two patients [7.67%] in the off-pump group, with a significant difference. Group [I] showed a significant increase of transfused blood, blood urea nitrogen, serum creatinine, acute kidney injury [13 patients], reopening for bleeding, postoperative renal impairment, need for renal dialysis, total intensive care unit stay, and the total duration of hospital admission. However, it had a significant reduction in hemoglobin and creatinine clearance. Conclusion: Off-pump coronary revascularization offers a better kidney function preservation and has a decreased risk for kidney dysfunction in patients with renal impairment without dialysis compared with coronary revascularization with cardiopulmonary bypass.
format	article
author	Khalid Abdelsamad Mohamed Shaffik Hassan Mohamed Eldesouky Sharaa Ismail Nasr Elsokkary
author_facet	Khalid Abdelsamad Mohamed Shaffik Hassan Mohamed Eldesouky Sharaa Ismail Nasr Elsokkary
author_sort	Khalid Abdelsamad
title	Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
title_short	Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
title_full	Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
title_fullStr	Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
title_full_unstemmed	Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study
title_sort	off-pump versus on-pump coronary artery bypass surgery in ischemic heart disease patients with impaired contractility and renal dysfunction: a comparative study
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/17b7e5b9c9924620b5685e0725bb11cf
work_keys_str_mv	AT khalidabdelsamad offpumpversusonpumpcoronaryarterybypasssurgeryinischemicheartdiseasepatientswithimpairedcontractilityandrenaldysfunctionacomparativestudy AT mohamedshaffikhassan offpumpversusonpumpcoronaryarterybypasssurgeryinischemicheartdiseasepatientswithimpairedcontractilityandrenaldysfunctionacomparativestudy AT mohamedeldesoukysharaa offpumpversusonpumpcoronaryarterybypasssurgeryinischemicheartdiseasepatientswithimpairedcontractilityandrenaldysfunctionacomparativestudy AT ismailnasrelsokkary offpumpversusonpumpcoronaryarterybypasssurgeryinischemicheartdiseasepatientswithimpairedcontractilityandrenaldysfunctionacomparativestudy
_version_	1718396693216493568

Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study

Ejemplares similares