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Ann Thorac Surg 2005;80:96-100
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Midterm Results of Surgical Treatment of Thoracic Aortic Disease in Dialysis Patients

Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan

Accepted for publication January 20, 2005.

^_* Address reprint requests to Dr Morishita, Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Central Ward, Sapporo, 060-8543 Japan (Email: kmori{at}sapmed.ac.jp).

BACKGROUND: We investigated the influence of dialysis on late aortic events in end-stage renal failure patients who had undergone replacement of the thoracic aorta.

METHODS: Between 1990 and 2003, 28 dialysis patients underwent thoracic aortic aneurysm repair. The cause was non-dissection in 17 patients and dissection in 11 patients. Six patients needed emergency operations. After the initial operation, 10 patients in the dialysis group had a patent false channel distal to the operative area, and 7 patients in the dialysis group had untreated separate aneurysms. These lesions were defined as residual aneurysms. We performed a retrospective case-control analysis of survival and late aortic events (enlargement of the remaining thoracic aorta, sudden death and reoperation) in dialysis patients versus carefully matched non-dialysis patients. Matching criteria included age, sex, cause, operative procedures, operative date, and operative status (elective or emergency).

RESULTS: Survival rates at 1 and 5 years for dialysis patients versus non-dialysis patients were 63 ± 9% vs. 85 ± 7% and 41 ± 11% versus 64 ± 13%, respectively (p = 0.02). Four of nine late deaths in the dialysis group were due to rupture of residual aneurysm. Freedom from late aortic events for dialysis patients versus non-dialysis patients was 91± 6% versus 92 ± 5% and 25 ± 14% versus 68 ± 12% at 1 and 5 years, respectively (p = 0.0073).

CONCLUSIONS: There is a high incidence of late aortic events in dialysis patients undergoing thoracic aortic aneurysm repair. This finding indicates the need for close follow-up examination of dialysis patients who have undergone surgical treatment of thoracic aortic disease.

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				M. Nakajima, K. Tsuchiya, O. Akashi, H. Morimoto, and K. Kato Thoracoabdominal Aortic Aneurysm Associated With Abdominal Aortic and Visceral Arterial Occlusion in a Hemodialysis Patient Ann. Thorac. Surg., June 1, 2007; 83(6): 2216 - 2219. [Abstract] [Full Text] [PDF]