ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Open heart surgery in dialysis-dependent patients with chronic kidney failure
Ahmet Refik Turgut1, Ersan Özbudak1, Ali Özerdem1, Emre Özker1, Nuket Bilginer2, Ali Sandıkçı3, Fuat Bilgen4
1 Özel Erdem Hastanesi, Kalp ve Damar Cerrahisi Bölümü, İstanbul
2 Özel Erdem Hastanesi, Anestezi Bölümü, İstanbul
3 Özel Erdem Hastanesi, Hemodiyaliz Bölümü, İstanbul
4 Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İstanbul
Background: Cardiac diseases are much more common in patients with chronic renal failure (CRF) than in the general population. We evaluated the results of cardiac surgery in patients with CRF.

Methods: The study included 28 dialysis-dependent patients with CRF (21 males, 7 females; mean age 59±9 years; range 42 to 76 years) who underwent cardiac surgery under cardiopulmonary bypass. Of these, 25 patients underwent coronary artery bypass surgery, one patient underwent coronary artery bypass surgery and aortic valve replacement, and two patients underwent cardiac valve surgery. Preoperative, perioperative, and postoperative data of the patients were retrospectively evaluated.

Results: The mean cross clamp time was 63±18 min and the mean perfusion time was 84±22 min. Seven patients needed inotropic support at the end of surgery, but inotropic support was discontinued in the first postoperative day in all the patients. None of the patients required revision. The mean amount of drainage was 440±110 ml. Five patients (18%) who developed atrial fibrillation returned to sinus rhythm after medical treatment. Three patients underwent thoracentesis due to pleural effusion. One patient developed wound infection. Mortality occurred in only one patient due to low cardiac output and multiorgan failure. The mean intensive care unit stay was 20±4 hours, and the mean hospital stay was 7±1 days. Postoperatively, all the patients continued dialysis treatment without cardiac symptoms.

Conclusion: Cardiac surgery with conventional cardiopulmonary bypass techniques can be performed with acceptable morbidity and mortality rates in dialysis-dependent patients with CRF.

Keywords : Coronary artery bypass; kidney failure, chronic/complications; renal dialysis
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