Objective: Patients with chronic renal insufficiency remain a risky subgroup in open heart surgery because of various reasons. The incidence of cardiovascular disease in hemodialysis dependent renal failure is found to be higher when compared with the normal population. Chronic dialysis is still a very important independent risk factor for mortality and morbidity despite of many studies. In this study, we retrospectively evaluated the outcome of patients with chronic renal failure who had undergone to open cardiac surgery.
Methods: The medical charts of 36 patients on maintenance dialysis who underwent cardiovascular surgery were retrospectively analyzed. Peroperative findings of these patients were analyzed from patients’ hospital records.
Results: Twenty-seven men (75%) and nine women (25%) totally 36 patients were included to study. The mean age was 58.3±8.5 (range, 44-76) years. 12 patients underwent coronary artery bypass surgery, 10 had concomitant coronary artery bypass surgery and valve replacements, five had valve replacements, three had concomitant coronary artery bypass surgery and left ventriculectomy, four had valve replacement with other valve repair, two had aortic surgery due to ascending aortic aneurysms. The mean cross clamp time was 78.1±31.3 min and the mean perfusion time was 158.8±92.2 min. The mean intensive care unit stay was 60±41 hours, and the mean hospital stay was 12±5 days. Hospital mortality rate was %38.8.
Conclusions: Cardiac and renal functions are closely associated with each other. Cardiac surgery operations can be applied to patients with end-stage renal failure under acceptable risks. Appropriate preoperative preparation with good postoperative patient follow-up is necessary to have acceptable levels of morbidity and mortality rates.