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Revascularización coronaria en pacientes mantenidos en hemodiálisis crónica
Circulation
|October 1, 1977
Resumen
La cirugía de derivación coronaria en pacientes con diálisis crónica es rara pero factible. Este estudio informa de dos casos exitosos, lo que demuestra que una planificación cuidadosa puede minimizar los riesgos para estos pacientes de alto riesgo.
Área de la Ciencia:
- Cardiología Cardiología.
- Nefrología Nefrología.
- Cirugía cardíaca Cirugía cardíaca.
Sus antecedentes:
- Las complicaciones cardiovasculares causan el 50-65% de las muertes en pacientes en diálisis crónica.
- La cirugía de derivación coronaria es cada vez más común en la población general.
- Pocos pacientes en hemodiálisis crónica se han sometido a una cirugía de derivación coronaria.
Objetivo del estudio:
- Para informar sobre la revascularización coronaria exitosa en dos pacientes en hemodiálisis crónica.
- Para esbozar estrategias de manejo para tales pacientes.
- Para evaluar el riesgo operativo de revascularización coronaria en pacientes con diálisis crónica.
Principales métodos:
- Informe de caso de dos pacientes sometidos a revascularización coronaria.
- Revisión del manejo de otros 13 pacientes con diálisis crónica que se sometieron a bypass cardiopulmonar.
- Descripción detallada de la atención preoperatoria, intraoperatoria y postoperatoria.
Principales resultados:
- Dos pacientes adicionales se sometieron con éxito a la revascularización coronaria mientras estaban en hemodiálisis crónica.
- Se proporcionan detalles de manejo para estos y otros 13 pacientes.
- Se observó un aumento mínimo del riesgo operativo con una planificación cuidadosa.
Conclusiones:
- La revascularización coronaria se puede realizar con seguridad en pacientes en diálisis crónica.
- La planificación y la gestión cuidadosas son cruciales para obtener resultados exitosos.
- Este procedimiento ofrece una opción viable para pacientes de diálisis seleccionados con enfermedad arterial coronaria.
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