Cardiac surgery in patients on hemodialysis: eight years experience of the Tunisian military hospital.
End-stage renal disease (ESRD) is known to be an important risk factor for cardiac operations performed with cardiopulmonary bypass. We investigated the influence of preoperative status on perioperative mortality and morbidity. We retrospectively analyzed data from 26 patients with ESRD, who were on maintenance dialysis and underwent a cardiac surgical procedure bet-ween 2000 and 2007. Of them, 61.5% of the patients had isolated coronary artery bypass grafting (CABG) and 38.5% had replacement or reconstruction of one or two valves. The perioperative mortality rate was 26% with five deaths occurring in patients undergoing CABG procedure. We found CABG procedure, being female and left ventricular (LV) function < 30% to be associated with a higher relative risk for perioperative death. In conclusion, our data suggest that both indi-cations and referral for surgical intervention for coronary artery disease may be delayed in pa-tients who have ESRD, contributing to the relatively high perioperative mortality.
Department of Anesthesia and Intensive Care, Tunisian Military Hospital, Tunis, Tunisia.
Hedi
H
Gharsallah
Walid
W
Trabelsi
Zied
Z
Hajjej
Mourad
M
Nasri
Anis
A
Lebbi
Mohamed Adel
MA
Jebali
Mustapha
M
Ferjani
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology; D016277:Ventricular Function, Left