LAUSR

Preoperative renal dysfunction is a major determinant of operative and long-term mortality following cardiac surgery. The objective of this study was to assess early and long-term results of CABG in patients with preoperative chronic kidney disease (CKD) using a bilateral internal thoracic artery (BITA) strategy, compared to those without CKD. We retrospectively analyzed data for 2,111 consecutive patients who underwent CABG with BITA between 2000-2019. One-to-many propensity score matching was performed to produce a cohort of 132 patients with CKD (defined as an estimated glomerular filtration rate<60 mL/min/1.73 m2), matched to 358 patients with normal renal function (non-CKD). The primary end-point of interest was late freedom from all-cause mortality. Late hospital readmissions were also assessed. Mean eGFR and serum creatinine were: 49.8 vs. 84.3 mL/min/m2 and 146.1 vs. 83.6 µmol/L (CKD vs. non-CKD, p<0.001). In-hospital outcomes were similar among matched patients, including mortality (CKD 0.8% vs. non-CKD 0%, p=0.31). At a median follow-up of 6.9 years, there was no significant difference in survival between both groups (hazard ratio (HR) 1.37, 95% confidence interval (CI) 0.87-2.16, p=0.17). Hospital readmission for cardiovascular causes (including repeat coronary revascularization) was comparable between the two groups. However, the risk of hospital readmission for renal causes was higher in patients with CKD (6.7%) compared to non-CKD (1.2%). In a propensity score-matched cohort of patients undergoing BITA-CABG, CKD was not associated with increased early or late mortality, nor was there a greater risk of hospital readmission for cardiovascular events.