Abstract 748: Long-Term Survival of Dialysis Patients Undergoing Off-Pump versus On-Pump Coronary Artery Bypass Surgery in the United States
Published data (Beckermann et al, J. Thorac Cardiovasc Surg. 2006) suggest superior outcomes in dialysis pts having coronary artery bypass surgery (CAB) without cardiopulmonary bypass (off-pump) compared to on-pump CAB. We searched the records of the United States Renal Data System database and identified 13,092 dialysis pts in 2001–2006 undergoing CAB (without valve surgery or prior CAB), with 2337 pts done “off-pump”. The impact of off-pump use on survival after CAB was assessed by Kaplan-Meier method and a comorbidity-adjusted Cox model. The pt group was 65% white, 62% male, 58% renal failure caused by diabetes, 47% 65+ yrs., 77% had internal mammary grafts and 72% had ≥3 arteries bypassed. In-hospital death was 11.0% for on-pump and 9.7% off-pump. Predictors of long-term mortality included older age, female gender, white race, diabetes, CHF, End Stage Renal Disease (ESRD):> 5 yrs, single vessel CAB, and on-pump CAB.. The Table⇓ shows survival and predictors of death. After adjustment for comorbidity, off-pump CAB is associated with decreased long-term mortality in dialysis pts.