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The Annals of Thoracic Surgery, Vol 42, 113-117, Copyright © 1986 by The Society of Thoracic Surgeons
JL Zamora, JT Burdine, H Karlberg, SM Shenaq and GP Noon
In a retrospective study we analyzed the clinical features of 85 patients
with end-stage renal disease who underwent cardiac operation. Seventy-eight
patients were from reports in the literature, and 7 were from our
experience. The cardiac procedures were primarily valve replacements and
aortocoronary bypass (ACB) operations. The indication for valve replacement
was most commonly infective endocarditis (73%), affecting most frequently
the aortic valve (68%). The most common organism was Staphylococcus aureus,
and there was a recent episode of angioaccess site infection in at least
17.5% of patients with documented endocarditis. The 30-day mortality was
57% for patients undergoing emergency valve replacement and only 3% for
similar elective operations. Cumulative survival at 48 months was equal to
that of the overall hemodialysis population not having cardiac operations.
The mean age (50 years), male to female ratio (9:1), number of vessels
bypassed per patient (2.4), and operative mortality for ACB were equal to
those reported in comparable series of patients with normal renal function.
Cumulative survival at 48 months for ACB patients was similar (60% versus
56%) to that of the overall hemodialysis population. Cardiac operations can
be performed safely in patients with end-stage renal disease; the morbidity
and mortality are similar to those encountered in patients with normal
renal function. The long-term survival after cardiac procedures in patients
with end-stage renal disease is similar to that reported for the overall
hemodialysis population not having cardiac operations.
ARTICLES
Cardiac surgery in patients with end-stage renal disease
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