Cardiovascular operations in patients with dialysis-dependent renal failure.
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 endstage renal disease may be performed with a fairly low perioperative risk and the perspective of long-term functional improvement and acceptable long-term survival.
Frenken
M
M
Department of Thoracic and Cardiovascular Surgery, Heart Center Duisburg, Germany.
Krian
A
A
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate