Open heart surgery in patients with end-stage renal disease.
Seventeen patients on maintenance dialysis therapy or with severe impaired kidney function required correction of cardiovascular diseases by open heart surgery. Ten aortic, two mitral valvular replacements and five coronary artery bypass grafts were performed. Special attention was taken for these patients, including pre-operative dialysis, cardiopulmonary bypass with complete haemodilution, composition of extracorporeal circuit volumes, arterial and venous access and myocardial protection. Prosthetic valves were preferred to porcine heterografts for valve replacements and autogenous saphenous veins were utilised for coronary artery bypass grafts. Follow-up of 14 patients was available from one to 84 months. Carefully planned open heart surgery can be successfully carried out in uraemic patients without an increased operative risk.
D000328:Adult; D006348:Cardiac Surgical Procedures; D002318:Cardiovascular Diseases / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis