[Peri-operative management and follow-up outcomes of cardiac surgery in dialysis-dependent patients with end stage renal disease].
OBJECTIVE
To summarize the perioperative management experience of patients with end-stage renal diseases (ESRD) undergoing cardiac surgery and the follow-up outcomes.


METHODS
From September 2004 to February 2012, 18 dialysis-dependent patients with ESRD received cardiac surgery in Department of Cardiac Surgery, Peking University First Hospital. A series of methods were employed to maintain water-electrolyte and acid-base balance and coagulation function. We followed up the patients by clinic service or telephone.


RESULTS
The spectra of surgical interventions included isolated coronary artery bypass graft (CABG, n=13), isolated valve replacement (VR, n=2) and concomitant CABG and VR (n=3). Of the 18 patients, 3 died within the Peri-operative period and 15 recovered and were discharged. The follow up period was 6-91 months [(27.6±27.5) months]. Within the follow up period, 2 patients died (66th month and 76th month), non-fatal complications occurred in 3 patients. Cardiac functions of the survived patients were good according to the New York Heart Association (NYHA) classification, 4 of them were within NYHA class I and 9 within NYHA class II.


CONCLUSIONS
Dialysis-dependent patients with end-stage renal diseases are a high risk group receiving cardiac surgery, but a comprehensive Peri-operative management of water-electrolyte and acid-base balance and coagulation function could yield a better outcome.
Department of Cardiac Surgery, Peking University First Hospital, Beijing 100034, China.
Xi-hui
XH
Li
Yan
Y
Li
Feng
F
Xiao
Yi-fan
YF
Li
Jin
J
Wang
Bo
B
Song
Yang
Y
Yang
Shi-yong
SY
Dong
D000136:Acid-Base Equilibrium; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis; D012307:Risk Factors