Early and Late Outcomes of Aortic Valve Replacement in Dialysis Patients

Tanaka, Keisuke; Tajima, Kazuyoshi; Takami, Yoshiyuki; Okada, Noritaka; Terazawa, Sachie; Usui, Akihiko; Ueda, Yuichi

doi:10.1016/j.athoracsur.2009.10.026

Cited by 57 publications

(82 citation statements)

References 17 publications

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“…The main causes of death in our series were ventricular tachycardia and ischemic colitis. Tanaka et al [7] have described the mechanism and prevention of these causes. The rapid correction of excess water is thought to be the cause of the collapse of the peripheral circulation that triggers ischemic colitis or abnormal blood levels of electrolytes, which might cause ventricular arrhythmia.…”

Section: Discussionmentioning

confidence: 98%

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Aortic valve prosthesis selection in dialysis patients based on the patient’s condition

et al. 2012

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Previous studies have examined outcomes in dialysis patients undergoing cardiac surgery. However, only a few studies have solely focused on outcomes after aortic valve replacement (AVR). This study aimed to clarify independent predictors of the long-term survival of dialysis patients with AVR and to determine whether a mechanical valve or bioprosthesis is suitable based on the patient's condition. A total of 38 consecutive dialysis patients who underwent AVR at our institute were reviewed (mean age 69.1 ± 9.4 years). There were 23 bioprostheses and 15 mechanical valve replacements. The operative mortality and the long-term survival were not different between the bioprosthesis and the mechanical valve group (13.0 vs. 13.3%). The significant multivariate predictors for long-term survival were concomitant coronary artery bypass grafting (CABG) and prosthesis size. Valve types and age at operation did not affect long-term survival. Five-year survival of patients with small prosthetic valves and concomitant CABG was 0%. When the patient's quality of life is taken into account, it may be appropriate to use a bioprosthesis in a dialysis patient with a small annulus and concomitant CABG even if the patient is young.

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Section: Discussionmentioning

confidence: 98%

“…However, many of these studies examined outcomes after all types of cardiac surgery. Only a few studies have solely focused on outcomes after aortic valve replacement (AVR) [7]. Single mitral valve replacement (MVR) was reported to have a 23% greater risk of death than AVR [8].…”

Section: Introductionmentioning

confidence: 99%

Aortic valve prosthesis selection in dialysis patients based on the patient’s condition

et al. 2012

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“…There was no significant difference in mid-term survival between bioprosthesis and mechanical valves. Of the 14 included studies, two studies (16,20) demonstrated a survival advantage in favour of mechanical prostheses over bioprosthesis and the remaining 12 studies failed to demonstrate a survival advantage according to prosthesis type. There was a significant reduction in bleeding events comparing bioprosthesis with mechanical valves (5.2% vs. 6.4%).…”

Section: Discussionmentioning

confidence: 99%

“…After exclusion of duplicate or irrelevant references, 40 potentially relevant articles were retrieved. After application of inclusion and exclusion criteria, 16 relevant articles were included in the present systematic review and meta-analysis (7,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). A total of 8,483 patients with ESRD were included for analysis, including 6,187 receiving bioprosthesis and 2,296 receiving mechanical valves.…”

Section: Literature Searchmentioning

confidence: 99%

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Phan

Tsai

Zhao

et al. 2016

Heart, Lung and Circulation

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“…Different studies on SAVR in dialysis patients have been performed [16,17,18], showing an increased surgical risk in these patients. The largest study of 5,858 dialysis patients undergoing surgical valve replacement found an in-hospital mortality rate of 20.7% [18].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Implantation in Dialysis Patients

Rau¹,

Lange

Kupatt

et al. 2012

Nephron Clin Pract

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Background/Aims: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option for high-risk patients. However, dialysis patients were excluded from all previous studies. The aim of this study is to compare the outcomes of TAVI for dialysis patients with those for patients with chronic kidney disease (CKD) stages 3 and 4 and to compare TAVI with open surgery in dialysis patients. Methods: Part I: comparison of 10 patients on chronic hemodialysis with 116 patients with non-dialysis-dependent CKD undergoing TAVI. Part II: comparison of transcatheter (n = 15) with open surgical (n = 24) aortic valve replacement in dialysis patients. Results: Part I: dialysis patients were significantly younger (72.3 vs. 82.0 years; p < 0.01). Hospital stay was significantly longer in dialysis patients (21.8 vs. 12.1 days; p = 0.01). Overall 30-day mortality was 3.17%, with no deaths among dialysis patients. Six-month survival rates were similar (log-rank p = 0.935). Part II: patient age was comparable (66.5 vs. 69.5 years; p = 0.42). Patients in the surgical group tended to stay longer in hospital than TAVI patients (29.5 vs. 22.5 days; p = 0.35). Conclusion: TAVI is a safe procedure in patients on chronic hemodialysis. Until new data become available, we find no compelling reason to refuse these patients TAVI.

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Early and Late Outcomes of Aortic Valve Replacement in Dialysis Patients

Cited by 57 publications

References 17 publications

Aortic valve prosthesis selection in dialysis patients based on the patient’s condition

Aortic valve prosthesis selection in dialysis patients based on the patient’s condition

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Transcatheter Aortic Valve Implantation in Dialysis Patients

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