{
    "abstract": "Little is known about graft patency after coronary artery bypass grafting (CABG) performed in patients on dialysis. Our aim was to assess patency of internal thoracic artery (ITA) grafts and saphenous vein grafts (SVGs) in these patients.\nFrom 1/1997 to 1/2018, 500 patients on dialysis underwent primary CABG with or without concomitant procedures at Cleveland Clinic, 40 of whom had 48 postoperative angiograms for recurrent ischemic symptoms. Complete follow-up was obtained on all but 1 patient lost to follow-up 1\u00a0y after CABG. Thirty-six ITA grafts and 65 SVGs were evaluable for stenosis and occlusion.\nTwo of 40 patients (5%) had emergency CABG; 3 (7.5%) with calcified aortas had a change in operative strategy to avoid ascending aortic manipulation, 2 (5%) had poor conduit quality, and 12 (30%) had severe diffuse atherosclerotic disease with calcification of the coronary targets causing technical difficulties. Thirty-three patients (82%) were bypassed with an in situ ITA and 3 (7.5%) had a free ITA graft. Three of 36 ITA grafts were occluded at 0.78, 1.8, and 9.4\u00a0y (too few to model). SVG patency was 52% and 37% at 1 and 2\u00a0y, respectively.\nAmong patients on dialysis who underwent CABG, coronary angiography for ischemic symptoms in a select subset revealed that SVG patency was lower than expected from published reports in the general CABG population and may contribute to the poor prognosis of this cohort. Further work is needed to guide graft selection and improve graft patency in dialysis patients.",
    "authors": [
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Shirin",
            "initials": "S",
            "lastname": "Siddiqi"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Kirthi",
            "initials": "K",
            "lastname": "Ravichandren"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Edward G",
            "initials": "EG",
            "lastname": "Soltesz"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Douglas R",
            "initials": "DR",
            "lastname": "Johnston"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Eric E",
            "initials": "EE",
            "lastname": "Roselli"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Michael Z",
            "initials": "MZ",
            "lastname": "Tong"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Jose L",
            "initials": "JL",
            "lastname": "Navia"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Haytham",
            "initials": "H",
            "lastname": "Elgharably"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Kamal",
            "initials": "K",
            "lastname": "Ayyat"
        },
        {
            "affiliation": "Department of Quantitative Health Sciences, Research Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Penny L",
            "initials": "PL",
            "lastname": "Houghtaling"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "G\u00f6sta B",
            "initials": "GB",
            "lastname": "Pettersson"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Department of Quantitative Health Sciences, Research Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Eugene H",
            "initials": "EH",
            "lastname": "Blackstone"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.",
            "firstname": "Lars G",
            "initials": "LG",
            "lastname": "Svensson"
        },
        {
            "affiliation": "Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: bakaeef@ccf.org.",
            "firstname": "Faisal G",
            "initials": "FG",
            "lastname": "Bakaeen"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2020 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jss.2020.03.069",
    "journal": "The Journal of surgical research",
    "keywords": [
        "Internal thoracic artery grafts",
        "Saphenous vein grafts"
    ],
    "methods": null,
    "publication_date": "2020-05-11",
    "pubmed_id": "32388058",
    "results": "Two of 40 patients (5%) had emergency CABG; 3 (7.5%) with calcified aortas had a change in operative strategy to avoid ascending aortic manipulation, 2 (5%) had poor conduit quality, and 12 (30%) had severe diffuse atherosclerotic disease with calcification of the coronary targets causing technical difficulties. Thirty-three patients (82%) were bypassed with an in situ ITA and 3 (7.5%) had a free ITA graft. Three of 36 ITA grafts were occluded at 0.78, 1.8, and 9.4\u00a0y (too few to model). SVG patency was 52% and 37% at 1 and 2\u00a0y, respectively.",
    "title": "Coronary Artery Bypass Graft Patency and Survival in Patients on Dialysis.",
    "xml": "<Element 'PubmedArticle' at 0x788502c67420>"
}