Considerations in the management of open-heart surgery in uremic patients.
Life-threatening complications involving the central circulation commonly occur in uremic patients. The growing number of individuals maintained on long-term hemodialysis along with repeated demonstrations of their ability to tolerate major operative procedures are responsible for increasing surgical experience in this group. Despite a high incidence of subacute bacterial endocarditis (SBE) and accelerated coronary atherosclerosis, exposure of such patients to open-heart operations has been limited. Our management of two patients who recently underwent valvular replacement is outlined and a review of the literature revealed that, during the past decade, 20 uremic patients have undergone a variety of cardiac procedures. The catastrophic results of medical therapy in such individuals with SBE are emphasized and early surgical intervention is recommended.
D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D011704:Pyelonephritis / Q000150:complications / Q000628:therapy; D006435:Renal Dialysis; D014262:Tricuspid Valve Insufficiency / Q000601:surgery