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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

[Open heart surgery in three patients receiving dialysis for more than 20 years]

T Ishida1, H Nishida, Y Tomizawa

  • 1Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|June 10, 2000
PubMed

Insights

Open heart surgery is feasible for long-term hemodialysis (HD) patients, even those with over 20 years on HD. Arterial grafts are recommended for coronary artery bypass grafting (CABG) in HD patients, with careful post-transplant management for kidney recipients.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Transplantation

Background:

  • The number of patients on chronic hemodialysis (HD) is rising in Japan, with a significant population exceeding 20 years on HD.
  • Open heart surgery in patients with long-term HD is uncommon and presents unique management challenges.

Observation:

  • Our institute has performed 135 open heart surgeries on HD patients, including 92 coronary artery bypass grafting (CABG) and 43 other procedures.
  • Three cases of open heart surgery were successfully performed on patients with over 20 years of HD history, including complex CABG and valve replacement procedures.

Findings:

  • All three patients with extended HD histories were discharged with patent grafts after surgery.
  • Aggressive use of arterial conduits for revascularization is advised for CABG in HD patients.
  • Post-kidney transplantation patients require meticulous management to prevent graft dysfunction and rejection.

Implications:

  • This study suggests that open heart surgery can be safely performed in select long-term HD patients.
  • The findings support the use of arterial grafts for improved outcomes in CABG for HD patients.
  • Careful perioperative and postoperative management is crucial for successful outcomes in this complex patient group.

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