Complex CABG in patient of renal failure.
- drpavankumar
- 0
- on Jun 17, 2021
Mr. A. N. 62 years old male has multiple illness of diabetes, hypertension, peripheral
Vascular disease and coronary artery disease since last 10 years . Recently he developed accelerated
Hypertension and angina . For this coronary angiography was done which showed heavily calcified
coronary arteries 100% occlusion of LAD & RCA with 90% block in circumflex artery LM 90% . His
heart pumping function was 40% . In other investigations he ha small right kidney as creatinine
clearance of 35 ml / s. creatinine 1.7 – 2mg/dl.
He underwent full work up & taken up for urgent coronary artery bypass surgery earlier in
December.
He underwent successful quadruple vessel coronary artery bypass surgery done on pump by Dr.
Pavan Kumar at Lilavati Hospital . He had smooth post- op period and recovery. At time of
discharged S. creatinine came down to 1.2 & heart function improved to 50% .
Discussion – Severe left main coronary artery disease with moderate renal failure is always a
complex scene to handle. These patients can turn into complications of total renal shutdown an
time during or after surgery. The protocol is to perform coronary bypass surgery on pump with use
of hemodialyzer. Hemodynamic monitoring & fluid / management by Swan Ganz catheter is also
very useful for optimal outcome to protect kidneys & perform full coronary revascularisation which
is not so easy in off pump surgery. Dr Pavan Kumar has now large numbers such patients of renal
failure undergoing successful CABG & well functioning kidneys after surgery