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Cardiac surgery in patients with moderate renal impairment
E Rick Gibbs1, Karla G Christian, Davis C Drinkwater
1Surgical Service, Department of Veterans Affairs Medical Center, Nashville, Tenn 37212, USA.
Background:
There is a paucity of information concerning the results of cardiac surgery in patients with moderate impairment of renal function. We reviewed our recent experience to determine the results of operation and the long-term outcome.
Methods:
Since January 1992, we have performed cardiac surgical procedures utilizing total cardiopulmonary bypass on 57 adult patients with preoperative serum creatinine values > or = 2.0 mg/dL and no history of dialysis. Operative procedures done were coronary artery bypass (39 patients), repeated coronary artery bypass (2), valve replacement with or without coronary artery bypass (12), and other procedures (4).
Results:
No operative deaths occurred. There were 3 hospital deaths. Only 5 patients required perioperative dialysis; in 5 additional patients, chronic dialysis was begun from 4 to 24 months postoperatively. The surviving patients who were not receiving dialysis had a mean creatinine value of 2.4 mg/dL at most recent follow-up.
Conclusions:
Adult patients with moderate renal impairment can safely have major cardiac procedures. The majority of patients maintain stable renal function postoperatively. The overall results of cardiac surgery in this patient population are good.