Current Issues in Coronary Revascularization for Hemodialysis Patients

Coronary artery bypass grafting (CABG) is advantageous for long-term clinical outcomes compared to percutaneous coronary intervention (PCI) in hemodialysis (HD) patients, as PCI has a lower short-term mortality but higher late revascularization risk. Therefore, CABG very important HD patients current practice. In the presence of an arteriovenous fistula may flow capacity ipsilateral internal thoracic (ITA) and induce steal, concomitant microvascular disease (MVD) can cause myocardial ischemia irreversible damage even after CABG. The use ITA free graft or contralateral left anterior descending be reasonable options. MVD complicates preoperative evaluation could worsen patients. Graft selection systemic circulation are mutually influential future concerns.