Document Detail


Results of isolated valve replacement in hemodialysis patients.
MedLine Citation:
PMID:  17911065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Frequent bleeding complications and poor long-term results have been reported after valve replacement in hemodialysis patients. We use mainly bileaflet mechanical valves with low-dose warfarin therapy (target international normalized ratio, 1.8-2.0) in such cases. Data of 27 hemodialysis patients undergoing isolated valve replacement from 1993 to 2002 were retrospectively analyzed. Bileaflet mechanical valves were selected in 23 patients and bioprostheses in 4. Those with mechanical valves were treated with mild anticoagulation therapy. There were 3 (11.1%) early deaths due to ischemic colitis, interstitial pneumonia, and ventricular arrhythmia. There were 3 late deaths and 5 bleeding complications during follow-up. The overall survival rate was 85.2% at 3 years and 72.9% at 5 years. The survival rate of patients with mechanical valves was 82.6% at 3 years and 76.7% at 5 years. One patient with a bioprosthesis experienced structural valvular deterioration after 3 years. The results demonstrate an acceptable long-term outcome. A bileaflet mechanical valve managed with mild anticoagulation therapy is a reasonable strategy for hemodialysis patients.
Authors:
Wataru Kato; Kazuyoshi Tajima; Sachie Terasawa; Keisuke Tanaka; Akihiko Usui; Yuichi Ueda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  15     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-03     Completed Date:  2008-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  386-91     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. kwataru@med.nagoya-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anticoagulants / adverse effects,  therapeutic use*
Arrhythmias, Cardiac / etiology
Bioprosthesis
Colitis, Ischemic / etiology
Female
Follow-Up Studies
Heart Valve Diseases / drug therapy,  etiology,  mortality,  surgery*
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / adverse effects*,  instrumentation
Hemorrhage / etiology
Humans
Kidney Failure / complications,  mortality,  therapy*
Lung Diseases, Interstitial / etiology
Male
Middle Aged
Patient Selection
Prosthesis Design
Prosthesis Failure
Renal Dialysis / adverse effects*
Retrospective Studies
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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