Cardiac Surgery in Dialysis-Dependent Patients: Impact of Gender on Early Outcome in Single-Center Experience with 204 Consecutive Cases

Deutsch, Oliver; Spiliopoulos, Kyriakos; Kiask, T; Katsari, Elpiniki; Rippinger, Nathalie; Eichinger, Walter; Gansera, Brigitte

doi:10.1055/s-0032-1331841

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…Renal insufficiency generally seems to have a stronger impact on women than on men. The investigation by Deutsch et al [ 26 ] evaluated the gender influence in dialysis-dependent patients undergoing cardiac surgery. The authors retrospectively reviewed the data of 204 dialysis-dependent patients (68.6% male, age 66.6 ± 9.9 years) with end-stage renal disease undergoing cardiac surgery and compared them to propensity-score-pair-matched controls, also consisting of 204 patients.…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

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Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

et al. 2014

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Background: Applying the gender lens to risk factors and outcome after adult cardiac surgery is of major clinical interest, as the inclusion of sex and gender in research design and analysis may guarantee more comprehensive cardiovascular science and may consecutively result in a more effective surgical treatment as well as cost savings in cardiac surgery. Methods: We have reviewed classical cardiovascular risk factors (diabetes, arterial hypertension, hyperlipidemia, smoking) according to a gender-based approach. Furthermore, we have examined comorbidities such as depression, renal insufficiency, and hormonal influences in regard to gender. Gender-sensitive economic aspects have been evaluated, surgical outcome has been analyzed, and cardiovascular research has been considered from a gender perspective. Results: The influence of typical risk factors and outcome after cardiac surgery has been evaluated from a gender perspective, and the gender-specific distribution of these risk factors is reported on. The named comorbidities are listed. Economic aspects demonstrated a gender gap. Outcome after coronary and valvular surgeries as well as after heart transplantation are displayed in this regard. Results after postoperative use of intra-aortic balloon pump are shown. Gender-related aspects of clinical and biomedical cardiosurgical research are reported. Conclusions: Female gender has become an independent risk factor of survival after the majority of cardiosurgical procedures. Severely impaired left ventricular ejection fraction independently predicts survival in men, whereas age does in females.

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Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

“…Multivariate analysis identified preoperative MI, prolonged extracorporeal circulation time, operation time, and surgical reexploration as independent predictors of 30-day mortality. There was a higher occurrence of bleeding complications in men that remained significant even after correction for body surface area [ 26 ].…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

et al. 2014

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“…These stark differences in short-term outcomes following cardiac surgical procedures become even more apparent with combined coronary artery bypass grafting plus valve surgeries (2.1-fold increase in mortality and a 1.7-1.8-fold increase in combined morbidity and mortality) [1]. A number of prospective and retrospective studies have shown consistent short-and long-term outcomes in this patient population, with 13-25% 30-day mortality [5][6][7][8], 18-19% 1-year mortality, 59-83% 5-year mortality, and an 81% 10-year mortality (median survival 4.3 years) [7,9]. This patient population also frequently requires complicated cardiac and aortic surgical procedures, and these more complex surgical procedures are also associated with higher shortand long-term morbidity and mortality compared to patients not on dialysis [10][11][12].…”

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confidence: 95%

Optimizing Perioperative Renal Replacement Therapy for Patients Undergoing Cardiac Surgical Procedures Requiring Cardiopulmonary Bypass

et al. 2022

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Coronary artery disease is highly prevalent in patients with end-stage renal disease (ESRD), and cardiovascular complications remain the most common cause of death in this patient population. Accordingly, many cardiac surgical procedures requiring cardiopulmonary bypass support are performed on these patients each year, with morbidity and mortality rates far exceeding patients without ESRD. Anuric patients lack the normal renal homeostatic functions which typically allow for physiologic protection from challenges during the operation, such as volume overload, hyperkalemia, and acidemia. Careful preoperative planning and coordination to provide pre-, intra-, and postoperative renal replacement therapies for such patients are imperative. Many different strategies have been reported in the literature. Zero-balance ultrafiltration is a newer strategy which utilizes convective ultrafiltration much like pre-filter continuous renal replacement therapy and utilizes pre-existing connections on the cardiopulmonary bypass pump performed by the perfusion team. This allows for control of potassium concentration throughout the operation with existing personnel and minimal additional equipment. Here, we describe the unique challenges caring for patients receiving renal replacement therapy undergoing cardiac surgical procedures requiring cardiopulmonary bypass.

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Implications for prosthesis selection in dialysis patients undergoing aortic valve replacement

Spiliopoulos,

Xanthopoulos,

Sideris

et al. 2024

Gen Thorac Cardiovasc Surg

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Cardiac Surgery in Dialysis-Dependent Patients: Impact of Gender on Early Outcome in Single-Center Experience with 204 Consecutive Cases

Cited by 5 publications

References 37 publications

Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

Optimizing Perioperative Renal Replacement Therapy for Patients Undergoing Cardiac Surgical Procedures Requiring Cardiopulmonary Bypass

Implications for prosthesis selection in dialysis patients undergoing aortic valve replacement

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