Beating heart valve surgery using stentless xenografts as a surgical alternative for patients with end-stage renal failure.
Patients suffering from end-stage renal disease are an inhomogeneous high-risk group with a substantial perioperative mortality and morbidity when undergoing cardiac surgical procedures[1-3]. Myocardial ischemia, reperfusion injury and myocardial edema are a few of the deleterious consequences of the traditional use of cardioplegic arrest when performing valve surgery,irrespective of the type of cardioplegia used [4-7]. Novel operative techniques are required to reduce these induced perioperative risks. Clinical studies in the past have demonstrated the efficacy of beating heart valve surgery in the high-risk patient using retrograde, antegrade or combined coronary perfusion with warm oxygenated blood [8, 9]. We chose to combine the superior hemodynamic profile of stentless xenografts with the concept of performing valve replacement on the empty beating heart with continuous antegrade application of oxygenated blood in 2 chronic hemodialysis patients.
Horst
M
M
Department of Cardiothoracic Surgery, Klinikum Oldenburg, Oldenburg, Germany.
Easo
J
J
Hölzl
P P
PP
Dapunt
O E
OE
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006355:Heart-Lung Machine; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014183:Transplantation, Heterologous; D016896:Treatment Outcome