[The perioperative management for the patients to undergo open heart surgery with chronic renal failure].
From January, 1996 to December, 1999, eight patients with chronic renal failure received open heart surgery. They consists of six males and two females aged between 45 and 72 with a mean of 59.6. The duration of hemodialysis was 4.0 years in a mean. Seven of them had isolated coronary artery bypass grafting (CABG), one of them had CABG and aortic valve replacement. All patients were dialysed dialy two days before operation. Intraoperative hemodialysis (HD) was used in all patients. In recent six patients extracorporeal ultrafiltration methods (ECUM) were also performed intraoperatively in addition to HD. In postoperatively continuous hemodiafiltration (CHDF) has been preferred to HD in all patients, and nafamostat mesilate is a useful anticoagulation agent to prevent postoperative bleeding complications. The duration of CHDF was 3.2 days in a mean (the shortest for one day and the longest for eight days). When the circulatory situation were stable, HD was performed on early postoperative day. One patients died of low output syndrome and multiple organ failure. We reported problems in perioperative management of patients with chronic renal failure and our protocol.
Maze
Y
Y
Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Mie, Japan.
Kanemitsu
S
S
Onoda
K
K
Shimono
T
T
Tanaka
K
K
Shimpo
H
H
Yada
I
I
D000368:Aged; D006348:Cardiac Surgical Procedures; D005112:Extracorporeal Circulation; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery; D019990:Perioperative Care; D006435:Renal Dialysis