Md. Abir Tazim Chowdhury

Evercare Hospital Dhaka, Bangladesh

Title: CABG on CKD Patients: A Single Center Experience in Bangladesh

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Biography

Dr. Chowdhury completed his MBBS (Hon's in Medicine) from Sylhet University of Science and Technology in 2011. Later, in 2020, he completed a Master of Surgery (MS) in Cardiovascular and Thoracic Surgery from Bangabandhu Sheikh Mujib Medical University, Dhaka. Dr. Chowdhury trained in different aspects of surgery and had vast working experience at government and private specialized institutes. Currently, he works as a Cardiovascular and Thoracic Surgeon Department of Cardiothoracic and Vascular Surgery at Evercare Hospital Dhaka, Bangladesh. He attended 1500+ general surgeries & 1500+ cardiac, vascular, and thoracic surgery in his little surgical carrier. He believes "A surgeon should respect every tissue of the patient's body during the cut and fix" and "A good surgeon must know how to fix complications of surgeries." Dr. Chowdhury presents scientific papers at several national and international conferences and publishes articles in various national and international reputed journals.

Abstract

Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events, and pre-dialysis patients of CKD  appear to be more likely to die of cardiac disease than kidney disease. CKD accelerates atherosclerosis by several mechanisms, notably hypertension and dyslipidemia, known risk factors for coronary artery disease (CAD). Moreover, calcium and phosphorus homeostasis is also altered in CKD. It may lead to hypercalcemia and vascular calcification in the coronary arteries. Regarding the revascularization technique for CAD, CABG is a favorable option compared to PCI. The choice of CABG is because it has lessened repeat revascularization, more significant relief of angina, and lengthened long-term survival. However, perioperative care is challenging to reduce operative risks.

A retrospective observational study was performed on CKD patients who underwent CABG in the cardiothoracic and vascular surgery departments in Evercare Hospital Dhaka, Bangladesh, between January 2020 to July 2022. The study's objective was to determine morbidity and early mortality after CABG. Of 425 patients who underwent isolated CABG, 65 patients who coexisted with CKD stage 2 and above were enrolled in the study. Enrolled patients were divided into the dialysis-dependent group (n=18) and the non-dialysis-dependent (n=47) CKD groups. The study analyzed the following variables- demographic characteristics, prolonged chest drainage, reopening, number of blood transfusions, prolonged hospital stay, mediastinitis, arrhythmias, respiratory tract infection, hypoalbuminemia, cardiovascular event, early readmission, and early mortality. Results of the study revealed that prolonged chest drainage, hospital stay, and arrhythmias were more significant in the dialysis-dependent group (p =<0.05). Moreover, one case of mortality and one of mediastinitis were found in the dialysis-dependent group. Dialysis-dependent CKD patients are burdened with comorbidities and biochemical changes, so they are vulnerable to postoperative adverse events. This retrospective study represents our experience to deals with CKD patients.