Beating-heart valve surgery in patients with renal failure requiring hemodialysis.
OBJECTIVE
The safety and efficacy of beating-heart valve surgery as a myocardial protection strategy was evaluated in patients with renal failure requiring hemodialysis.


METHODS
This was a retrospective review of nine patients (four males, five females; mean age 46.7 years; mean duration of hemodialysis 47 +/- 49 months) who underwent beating-heart valve surgery at the present authors' institution between April 2000 and September 2002.


RESULTS
The mean cardiopulmonary bypass time was 77.2 +/- 8 min. Perioperatively, two patients died (one from sepsis; one from complication of anticoagulation). There were no deaths in the follow up since discharge, with average follow up 18.3 months (range: 9-27 months). Other complications included reintubation for <24 h (one case), AV graft thrombosis (one patient) and stroke (one patient, as mentioned above). There were no new cardiac (including arrhythmia and low cardiac output syndrome) or metabolic complications (including hyperkalemia and fluid overload).


CONCLUSIONS
This is the first report of beating-heart valve surgery using simultaneous antegrade and retrograde perfusion with normothermic blood. Despite being small in size, the study demonstrated the safety of this approach in a high-risk population with renal failure requiring hemodialysis. The results suggested a low incidence of complications, and short ICU and hospital stays.
Masroor
Saqib
S
Division of Cardiothoracic Surgery, University of Miami-Jackson Memorial Hospital, Miami, Florida 33136, USA.
Lombardi
Pierluca
P
Tehrani
Hasan
H
Yassin
Said F
SF
Katariya
Kushagra
K
Salerno
Tomas A
TA
D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005431:Florida; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000097:blood / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000401:mortality; D006435:Renal Dialysis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D016277:Ventricular Function, Left / Q000502:physiology
D015415:Biomarkers