In situ skeletonized gastroepiploic artery grafting in hemodialysis patients

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ORIGINAL ARTICLE

In situ skeletonized gastroepiploic artery grafting in hemodialysis patients Kohei Hachiro1 · Takeshi Kinoshita1   · Tomoaki Suzuki1 · Tohru Asai1 Received: 31 March 2020 / Accepted: 12 May 2020 © The Japanese Association for Thoracic Surgery 2020

Abstract Objectives  There is no firm treatment strategy of coronary artery bypass grafting in hemodialysis patients. We investigated postoperative outcomes in hemodialysis patients undergoing isolated coronary artery bypass grafting using in situ skeletonized gastroepiploic artery. Methods  From January 2002 to December 2019, 143 hemodialysis patients underwent isolated coronary artery bypass grafting in our institution. Among them, 49 consecutive patients with gastroepiploic artery grafting were retrospectively analyzed. Results  No patient was converted from off-pump to on-pump surgery. The mean distal anastomoses were 3.6 ± 1.0 per patients. Seven patients (14.3%) required proximal anastomosis to aorta. Thirty-day mortality was 4.1% (2 of 49). The early (3–20 days after surgery) patency rate of the gastroepiploic artery was 96.9% (63 of 65 anastomoses). The adjusted rates of survival free from overall death at 1, 5 and 10 years after surgery were 91.7%, 72.6% and 32.5%, respectively. Multivariate Cox proportional hazard regression analysis showed that age (hazard ratio 1.131, 95% confidence interval 1.055–1.212, p