Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 27;32(6):864-872.
doi: 10.1093/icvts/ivab022.

Internal thoracic artery graft ipsilateral to the arteriovenous fistula in haemodialysis patients

Kohei Hachiro  1 , Takeshi Kinoshita  1 , Tomoaki Suzuki  1 , Tohru Asai  1
Affiliations

Internal thoracic artery graft ipsilateral to the arteriovenous fistula in haemodialysis patients

Kohei Hachiro et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: The aim of this study was to investigate the impact of in situ internal thoracic artery (ITA) grafting ipsilateral to the arteriovenous fistula (AVF) on postoperative outcomes in haemodialysis patients undergoing isolated coronary artery bypass grafting (CABG).

Methods: We reviewed 132 haemodialysis patients who underwent isolated CABG between January 2002 and December 2019. With a difference between the left and right upper arms blood pressure measurement of ≥20 mmHg, we did not use the ITA on the lower value side. We categorized patients into 55 patients (41.7%, ipsilateral group) whose left anterior descending artery was revascularized using the in situ ITA ipsilateral to the AVF, and 77 patients (58.3%, contralateral group) whose left anterior descending artery was revascularized using the ITA opposite the AVF. We compared patients' postoperative outcomes after adjusting for their backgrounds using weighted logistic regression analysis and inverse probability of treatment weighting.

Results: No patients developed coronary steal postoperatively, and there was no significant difference in 30-day mortality between the groups (P = 0.353). The adjusted 5-year estimated rates of freedom from all-cause and cardiac death in the ipsilateral vs contralateral groups were 52.3% vs 54.0% and 78.2% vs 88.6%, respectively; survival curves were not statistically significantly different (P = 0.762 and P = 0.229, respectively).

Conclusions: In situ ITA grafting ipsilateral to the AVF was not associated with postoperative early and mid-term worse outcomes in haemodialysis patients undergoing isolated CABG.

Keywords: Coronary artery bypass grafting; Haemodialysis patients; Side of arteriovenous fistula.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Freedom from overall death.
Figure 2:
Figure 2:
Freedom from cardiac death.
None
See this image and copyright information in PMC

References

    1. Herzog CA, Ma JZ, Collins AJ.. Comparative survival of dialysis patients in the United State after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery and impact of diabetes. Circulation 2002;106:2207–11. - PubMed
    1. Sunagawa G, Komiya T, Tamura N, Sakaguchi G, Kobayashi T, Murashita T.. Coronary artery bypass surgery is superior to percutaneous coronary intervention with drug-eluting stents for patients with chronic renal failure on hemodialysis. Ann Thorac Surg 2010;89:1896–900; discussion 1900. - PubMed
    1. Terazawa S, Tajima K, Takami Y, Tanaka K, Okada N, Usui A. et al. Early and late outdomes of coronary artery bypass surgery versus percutaneous coronary intervention with drug-eluting stents for dialysis patients. J Card Surg 2012;27:281–7. - PubMed
    1. Gaudino M, Serricchio M, Luciani N, Giungi S, Salica A, Pola R. et al. Risks of using internal thoracic artery grafts in patients in chronic hemodialysis via upper extremity arteriovenous fistula. Circulation 2003;107:2653–5. - PubMed
    1. Kato H, Ikawa S, Hayashi A, Yokoyama K.. Internal mammary artery steal in a dialysis patient. Ann Thorac Surg 2003;75:270–1. - PubMed

MeSH terms