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Asian Cardiovasc Thorac Ann 2007;15:19-23
© 2007 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Risk Evaluation and Midterm Outcome of Cardiac Surgery in Patients on Dialysis

Noriko Boku, MD, Munetaka Masuda, MD, Masataka Eto, MD, Takahiro Nishida, MD, Shigeki Morita, MD, Ryuji Tominaga, MD

Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

For reprint information contact: Munetaka Masuda, MD Tel: 81 45 787 2644 Fax: 81 45 786 0226 Email: mmasuda{at}yokohama-cu.ac.jp, Department of Surgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

The medical charts of 54 patients on maintenance dialysis who underwent cardiovascular surgery (37 elective and 17 urgent/emergency) from 1994 to 2004 were retrospectively analyzed. Thirty patients had coronary artery bypass grafting (17 elective and 13 urgent/emergency), 18 had valve replacement (16 elective and 2 urgent/emergency), and 6 underwent aortic surgery (4 elective and 2 urgent/emergency). The overall early mortality rate was 11.1%, comprising 2 patients (5.4%) who had elective operations and 4 (23.5%) who had urgent or emergency operations ( p = 0.049). The overall 5-year survival rate was 48.4%. The 5-year survival rate was 67.2% for elective surgery and 10.5% for urgent/emergency surgery ( p = 0.0001). The midterm clinical results after elective cardiovascular surgery were acceptable, whereas the results after urgent/emergency surgery were poor. For elective surgery, sufficient and detailed preoperative examinations might have contributed to the better operative outcome. Early diagnosis and consultation to avoid urgent/emergency operations in dialysis patients is recommended.






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