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Cardiac operation and end-stage renal disease
The Annals of Thoracic Surgery
|September 1, 1980
Summary
Cardiac surgery in patients with end-stage renal disease requiring dialysis is feasible. These interventions improve cardiac function, potentially facilitating successful renal transplantation.
Area of Science:
- Cardiology
- Nephrology
- Cardiovascular Surgery
Background:
- End-stage renal disease (ESRD) presents complex challenges for cardiac surgery.
- Patients with ESRD often have multiple comorbidities impacting surgical outcomes.
Purpose of the Study:
- To evaluate the outcomes of cardiac operations in patients with ESRD.
- To assess the impact of cardiac surgery on renal function and transplantation eligibility.
Main Methods:
- Retrospective analysis of 22 patients with ESRD undergoing 23 cardiac operations between 1972-1979.
- Procedures included coronary artery bypass grafting, valve replacement, and aortic root replacement.
- Management involved preoperative and postoperative dialysis, and assessment of renal transplant status.
Main Results:
- A low overall mortality rate of 9.1% (2 deaths).
- Significant functional improvement in patients undergoing coronary artery bypass grafting (NYHA Class III/IV to I/II).
- Eighteen patients required dialysis; 4 had successful subsequent renal transplants.
Conclusions:
- Cardiac operations can be safely performed in ESRD patients with complex medical issues.
- Improved cardiac status can simplify dialysis management and enhance eligibility for renal transplantation.
- Cardiac surgery may positively influence outcomes for selected ESRD patients awaiting or undergoing renal transplantation.