title: Aortic valve prosthesis selection in dialysis patients based on the patient's condition.
abstract: Previous studies have examined outcomes in dialysis patients undergoing cardiac surgery. However, only a few studies have solely focused on outcomes after aortic valve replacement (AVR). This study aimed to clarify independent predictors of the long-term survival of dialysis patients with AVR and to determine whether a mechanical valve or bioprosthesis is suitable based on the patient's condition. A total of 38 consecutive dialysis patients who underwent AVR at our institute were reviewed (mean age 69.1 ± 9.4 years). There were 23 bioprostheses and 15 mechanical valve replacements. The operative mortality and the long-term survival were not different between the bioprosthesis and the mechanical valve group (13.0 vs. 13.3%). The significant multivariate predictors for long-term survival were concomitant coronary artery bypass grafting (CABG) and prosthesis size. Valve types and age at operation did not affect long-term survival. Five-year survival of patients with small prosthetic valves and concomitant CABG was 0%. When the patient's quality of life is taken into account, it may be appropriate to use a bioprosthesis in a dialysis patient with a small annulus and concomitant CABG even if the patient is young.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan. fukui0104@yahoo.co.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukui
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamamura
authors.forename: Masataka
authors.initials: M
authors.lastname: Mitsuno
authors.forename: Hiroe
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ryomoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D015996:Survival Rate; D016896:Treatment Outcome