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Ann Thorac Surg 1999;68:887-893
© 1999 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, Heart Center Duisburg, Duisburg, Germany
Address reprint requests to Dr Frenken, Chirurgische Abteilung, Städtisches Krankenhaus Düsseldorf-Gerresheim, Gräulingerstrasse 120, 40625 Düsseldorf, Germany
Background. Cardiac operations in patients with end-stage renal disease carry a significantly increased perioperative risk, and long-term functional results and survival are still purely defined.
Methods. Therefore, we performed a retrospective analysis of 45 consecutive patients with dialysis-dependent renal failure who underwent either coronary artery bypass grafting (n = 30), valve replacement or combined procedures (n = 13), or pericardiotomy (n = 2). Mean age of the patients was 59 ± 10 years.
Results. There were two perioperative deaths (30-day mortality, 4.4%). Actuarial survival rates at 1, 2, 3, and 5 years were 0.90, 0.73, 0.67, and 0.67, respectively, after bypass operation and 0.77, 0.77, 0.77, and 0.39, respectively, after valvular or combined operation. Late deaths (n = 13) occurred 2 to 60 months after operation and were attributable to cardiac events in 7 patients. Of the long-term survivors after either bypass grafting (n = 20) or a valvular or combined procedure (n = 8), 15 and 7 patients had improved anginal status and New York Heart Association functional status, respectively, after 36 ± 4 months (range, 21 to 66 months). Five patients underwent renal transplantation 32 ± 9 months after cardiac operation.
Conclusions. Cardiac operations in patients with end-stage renal disease may be performed with a fairly low perioperative risk and the perspective of long-term functional improvement and acceptable long-term survival.
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