If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Valve Replacement Safe for Patients With End-Stage Renal Disease on Dialysis: Presented at STS By Charlene Laino FORT LAUDERDALE, Fla -- January 28, 2010 -- Valve replacement with both biological and mechanical prostheses carries acceptable operative mortality in patients with end-stage renal disease on chronic dialysis, researchers stated here on January 26 at the Society of Thoracic Surgeons (STS) 46th Annual Meeting. Choice of valve prosthesis should be made on an individual patient basis after careful risk assessment in this high-risk population, said Vinod H. Thourani, MD, Division of Cardiothoracic Surgery, Emory University Hospital Midtown, Atlanta, Georgia. “A significant portion of patients with end-stage renal disease requiring dialysis suffer from acquired heart disease, but the choice of valve prosthesis on postoperative survival [in these patients] is not well understood,” said Dr. Thourani. Therefore, the researchers studied mortality rates among 202 patients with end-stage renal disease who underwent 211 valve replacement surgeries between 1996 and 2007 at a US academic centre. The mean age of the patients, 55% of whom were male, was 55 years. Of the 211 surgeries, 100 (47.4%) were isolated aortic procedures, 49 (23.2%) were isolated mitral procedures, 4 (1.9%) were isolated tricuspid procedures, and 58 (27.5%) involved combined replacements. Thirteen (6.2%) patients underwent reoperative valve replacements. About two-thirds of patients (139/211; 65.9%) received bioprosthetic valves, while 72 (34.1%) received mechanical valves. Concomitant coronary artery bypass was performed in 53 (25.1%) patients. Forty-two patients died in the first 30 days after surgery. “This corresponded to a 30-day mortality rate of 19.9%,” said Dr. Thourani. The 30-day mortality rates among patients who received bioprosthetic valves and mechanical valves were 18.7% and 22.2%, respectively, which was not significantly different (P = .60). Rates of myocardial infarction, stroke, pneumonia, and septicaemia also did not differ between the 2 groups. The 10-year survival rate was 18.1% for all patients and again was not influenced by type of valve implanted: 16.9% and 20.3% for patients who received bioprosthetic valves and mechanical valves, respectively (P = NS). [Presentation title: Long-Term Survival for Bioprosthetic Valve Replacement Is Similar to Mechanical Valve Replacement in Patients With Preoperative End Stage Renal Failure. Abstract 11]
|
