The Journal of heart valve disease · 2004
Beating-heart valve surgery in patients with renal failure requiring hemodialysis.
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Masroor Saqib, Lombardi Pierluca, Tehrani Hasan, Yassin Said F, Katariya Kushagra, Salerno Tomas A
Аннотация
BACKGROUND AND AIM OF THE STUDY: The safety and efficacy of beating-heart valve surgery as a myocardial protection strategy was evaluated in patients with renal failure requiring hemodialysis.
METHODS: This was a retrospective review of nine patients (four males, five females; mean age 46.7 years; mean duration of hemodialysis 47 +/- 49 months) who underwent beating-heart valve surgery at the present authors' institution between April 2000 and September 2002.
RESULTS: The mean cardiopulmonary bypass time was 77.2 +/- 8 min. Perioperatively, two patients died (one from sepsis; one from complication of anticoagulation). There were no deaths in the follow up since discharge, with average follow up 18.3 months (range: 9-27 months). Other complications included reintubation for <24 h (one case), AV graft thrombosis (one patient) and stroke (one patient, as mentioned above). There were no new cardiac (including arrhythmia and low cardiac output syndrome) or metabolic complications (including hyperkalemia and fluid overload).
CONCLUSION: This is the first report of beating-heart valve surgery using simultaneous antegrade and retrograde perfusion with normothermic blood. Despite being small in size, the study demonstrated the safety of this approach in a high-risk population with renal failure requiring hemodialysis. The results suggested a low incidence of complications, and short ICU and hospital stays.
METHODS: This was a retrospective review of nine patients (four males, five females; mean age 46.7 years; mean duration of hemodialysis 47 +/- 49 months) who underwent beating-heart valve surgery at the present authors' institution between April 2000 and September 2002.
RESULTS: The mean cardiopulmonary bypass time was 77.2 +/- 8 min. Perioperatively, two patients died (one from sepsis; one from complication of anticoagulation). There were no deaths in the follow up since discharge, with average follow up 18.3 months (range: 9-27 months). Other complications included reintubation for <24 h (one case), AV graft thrombosis (one patient) and stroke (one patient, as mentioned above). There were no new cardiac (including arrhythmia and low cardiac output syndrome) or metabolic complications (including hyperkalemia and fluid overload).
CONCLUSION: This is the first report of beating-heart valve surgery using simultaneous antegrade and retrograde perfusion with normothermic blood. Despite being small in size, the study demonstrated the safety of this approach in a high-risk population with renal failure requiring hemodialysis. The results suggested a low incidence of complications, and short ICU and hospital stays.
Предметные рубрики MeSH
AdultAortic ValveBiomarkersFemaleFloridaFollow-Up StudiesHeart Valve DiseasesHeart Valve Prosthesis ImplantationHumansIntensive Care UnitsKidney Failure, ChronicLength of StayMaleMiddle AgedMitral ValvePostoperative ComplicationsRenal DialysisRetrospective StudiesStroke VolumeSurvival AnalysisTreatment OutcomeTricuspid ValveVentricular Function, Left