| Cardiac surgery in patients on chronic hemodialysis: short and long-term survival. | |
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MedLine Citation:
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PMID: 18365968 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Open-heart surgery carries a high risk for hemodialysis patients. This study focuses on the short and long-term outcomes of hemodialysis patients undergoing heart surgery. DESIGN: The study was carried out as a retrospective analysis in the Department of Cardiothoracic Surgery in a large university-affiliated hospital. PATIENTS: 115 hemodialysis patients underwent cardiac surgery in our department between 1 July 1996 and 31 July 2006. 67.5 % (77 patients) underwent isolated coronary artery bypass grafting (CABG), 13.2 % (15 patients) underwent isolated aortic valve replacement (AVR) and 20.2 % (23 patients) underwent mitral valve surgery or combined valve and coronary artery bypass grafting or multiple valve surgery. METHODS: The relationship between several variables (age, sex, hypertension, diabetes, and previous myocardial infarction, type of disease, preoperative ejection fraction, and congestive heart failure) and operative (30 days) mortality and late survival was analyzed. RESULTS: The overall 30-day mortality was 18.3 % (21 patients). It was 13 % (10/77 patients) for the isolated CABG group and 13.3 % (2/15) for the isolated AVR group. Patients undergoing combined valve and coronary surgery or multiple valve surgery had a higher perioperative mortality of 39.1 % (9/23) compared to the isolated CABG and isolated AVR patients. Perioperative death was also higher in patients with moderate and severe LV dysfunction, and in patients with diabetes. The duration of dialysis periods was not related to perioperative death. Mean follow-up was 26.4 +/- 29.7 months (0.1 to 104 months). Actuarial survival at 1 year and 5 years was 76 % and 55 % for isolated CABG, 59 % and 21 % for isolated AVR, and 44 % and 33 % for all other cases, respectively (log rank P = 0.001). CONCLUSION: Patients on dialysis have a high risk of perioperative mortality and poor long-term survival rates. Mortality is higher and survival is worse after combined CABG and valve-related procedures or multiple valve surgery than after isolated CABG and AVR. |
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Authors:
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A Kogan; B Medalion; R Kornowski; E Raanani; E Sharoni; A Stamler; G Sahar; E Snir; E Porat |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Thoracic and cardiovascular surgeon Volume: 56 ISSN: 0171-6425 ISO Abbreviation: Thorac Cardiovasc Surg Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-27 Completed Date: 2008-08-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903387 Medline TA: Thorac Cardiovasc Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 123-7 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery, Rabin Medical Center, Petah Tiqwa, Israel. alexander.kogan@sheba.health.gov.il |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cardiac Surgical Procedures / mortality* Cardiovascular Diseases / complications, mortality, surgery* Female Follow-Up Studies Humans Israel / epidemiology Kidney Failure, Chronic / complications, mortality, therapy* Male Middle Aged Prognosis Renal Dialysis / mortality* Retrospective Studies Risk Factors Survival Rate / trends Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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