Preoperative and intraoperative characteristics of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.

Preoperative and intraoperative characteristics of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.</p

Standardized mean difference plot before and after matching.

Standardized mean difference plot before and after matching.</p

Early outcomes of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.

Early outcomes of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.</p

Kaplan-Meier curve of survival for the unmatched cohort.

Kaplan-Meier curve of survival for the unmatched cohort.</p

STROBE statement—checklist of items that should be included in reports of observational studies—PONE-D-23-11606.

STROBE statement—checklist of items that should be included in reports of observational studies—PONE-D-23-11606.</p

Kaplan-Meier curve of survival for the matched cohort.

Kaplan-Meier curve of survival for the matched cohort.</p

Kaplan-Meier survival curves for each estimated glomerular ‎filtration rate group: eGFR≤15, 15>eGFR≤30, 3045 mL/min/1.73m2.

Kaplan-Meier survival curves for each estimated glomerular ‎filtration rate group: eGFR≤15, 15>eGFR≤30, 3045 mL/min/1.73m2.</p

Flow diagram of the study.

ObjectiveThe optimal strategy for surgical revascularization in patients with impaired renal function is inconclusive. We compared early and late outcomes between bilateral internal thoracic artery (BITA) and single ITA (SITA) grafting in patients with renal dysfunction.MethodsThis is a retrospective analysis of all the patients with multivessel disease and impaired renal function (estimated glomerular filtration rate 2) who underwent isolated coronary artery bypass graft (CABG) in our center during 1996–2011, utilizing either BITA or SITA revascularization.ResultsOf the 5301 patients with multivessel disease who underwent surgical revascularization during the study period, 391 were with impaired renal function: 212 (54.2%) underwent BITA, 179 (45.8%) underwent SITA. Patients who underwent BITA were less likely to have comorbidities. Statistically significant differences were not observed between the BITA and SITA groups in 30-day mortality (5.6% vs. 9.0%, p = 0.2) and in rates of early stroke, myocardial infarction, and sternal infection (4.5% vs. 6.1%, p = 0.467; 1.7% vs. 2.8%, p = 0.517; and 2.2% vs. 5.7%, p = 0.088, respectively). Long-term survival of the BITA group was better: median 8.36 vs. 4.14 years, pConclusionsBITA revascularization did not impact early outcome in patients with CRF, but demonstrated a significant protective effect on long-term survival ‎in the unmatched and matched cohorts.</div

Univariate Cox regression of additional factors that significantly affected 20-year survival of patients with chronic renal failure who underwent bilateral internal thoracic artery grafting.

Univariate Cox regression of additional factors that significantly affected 20-year survival of patients with chronic renal failure who underwent bilateral internal thoracic artery grafting.</p

Univariate and multivariable analysis for the association between the ‎surgical strategy (BITA vs. SITA) and patient survival.

Univariate and multivariable analysis for the association between the ‎surgical strategy (BITA vs. SITA) and patient survival.</p