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Strict control of phosphorus concentration of hemodialysis patients may decrease structural valve deterioration after
Seimei Go1, Tomokuni Furukawa2, Kazunori Yamada2
1Department of Cardiovascular Surgery, Hiroshima University, Kasumi 1-2-3, Minamiku, Hiroshima, Hiroshima, Japan. go55@hiroshima-u.ac.jp.
General Thoracic and Cardiovascular Surgery
|November 19, 2021
Summary
Bioprosthetic aortic valve replacement in hemodialysis patients carries a risk of structural valve deterioration (SVD). High preoperative phosphorus levels are linked to increased SVD risk, suggesting phosphorus control may improve outcomes.
Area of Science:
- Cardiology
- Nephrology
- Biomaterials Science
Background:
- Increasing number of hemodialysis patients require aortic valve replacement (AVR).
- Bioprosthetic valves are commonly used for AVR but risk structural valve deterioration (SVD).
Purpose of the Study:
- To evaluate outcomes of bioprosthetic valves in hemodialysis patients undergoing AVR.
- To identify strategies to mitigate SVD risk in this population.
Main Methods:
- Retrospective analysis of 61 hemodialysis patients undergoing AVR with bioprosthetic valves (2010-2019).
- Kaplan-Meier survival estimates and univariate Cox regression analyses were performed.
- Focus on structural valve deterioration (SVD) events and survival rates.
Main Results:
- Six SVD events (10.7%) occurred, all due to aortic stenosis, with a mean onset of 41.5 months post-AVR.
- 3-year and 5-year survival rates were 67.9% and 39.5%, respectively.
- High preoperative phosphorus levels were significantly associated with an elevated SVD risk.
Conclusions:
- Preoperative phosphorus levels are a modifiable factor influencing SVD risk after AVR in hemodialysis patients.
- Strict control of phosphorus levels in hemodialysis patients may reduce the incidence of SVD.
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