Results of Valve Replacement With Mechanical and Biological Prostheses in Chronic Renal Dialysis Patients

Lucke, John C.; Samy, Ravi N.; Atkins, B. Zane; Silvestry, Scott C.; Douglas, James M.; Schwab, Sidney I.; Wolfe, Walter G.; Glower, Donald D.

doi:10.1016/s0003-4975(97)00342-1

Cited by 68 publications

(59 citation statements)

References 14 publications

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“…Baglin et al 2 reported a 30-day survival of 74% and a 2-year survival of 54% in 61 dialysis patients undergoing valve surgery (of whom 60 had valve replacement) in France. In a series of 19 patients described by Lucke et al, 6 the 30-day mortality was 16%, and the estimated survival was 60Ϯ12% at 1 year and 42Ϯ14% at 5 years. Horst et al 4 reported perioperative mortality in 7 of 32 dialysis patients (22%) undergoing valve replacement at the University of Cologne in Germany.…”

Section: Discussionmentioning

confidence: 92%

“…In this retrospective analysis, the perioperative mortality was 19.3% for isolated cardiac valve procedures in 192 patients and 39.5% for combined CABG and valve replacement in 38 patients. With the inclusion of recent publications by Lucke et al, 6 Baglin et al, 2 Frenken and Krian, 22 Ura et al, 7 and Kaplon et al, 5 an additional 146 dialysis patients have Estimated all-cause survival of dialysis patients after heart valve replacement surgery with tissue and nontissue prosthetic valves. Bars indicate standard errors.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Two recent publications have challenged the practice of avoiding insertion of bioprosthetic valves in dialysis patients. 5,6 The purpose of this study was to compare the long-term survival of dialysis patients in the United States after heart valve replacement with mechanical prosthetic or bioprosthetic cardiac valves. Using the US Renal Data System (USRDS) database, we examined the outcome of 5858 chronic dialysis patients after heart valve replacement.…”

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confidence: 99%

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Long-Term Survival of Dialysis Patients in the United States With Prosthetic Heart Valves

2002

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Background — Minimal data exist on the long-term survival of dialysis patients after cardiac valve surgery. Current practice guidelines of the American College of Cardiology/American Heart Association Task Force on the management of patients with valvular heart disease proscribe the use of bioprosthetic (tissue) valves in hemodialysis patients. Methods and Results — Dialysis patients hospitalized for heart valve replacement surgery from 1978 to 1998 were retrospectively identified from the US Renal Data System database. Long-term survival was estimated by the life-table method. The impact of demographic differences and comorbidity on outcome were examined in a Cox proportional hazards model. The in-hospital mortality of 5858 dialysis patients undergoing valve surgery was 20.7%. Aortic valve replacement was performed in 3415 patients (58%), mitral valve replacement in 1848 patients (32%), and combined aortic and mitral valve replacement in 562 patients (10%). Tissue valves were used in 881 patients. There was no significant difference in survival related to type of prosthetic valve. The 2-year survival rate was 39.7±3.5% with tissue valves versus 39.7±1.4% for nontissue valves. Compared with nontissue prosthetic valves, the use of tissue valves was not predictive of death (RR 0.98; 95% CI 0.90 to 1.07). Conclusions — There is no significant difference in survival of dialysis patients after cardiac valve replacement with tissue versus nontissue prosthetic valves. Current practice guidelines proscribing the use of bioprosthetic heart valves in hemodialysis patients should be rescinded.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Long-Term Survival of Dialysis Patients in the United States With Prosthetic Heart Valves

2002

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“…However, current studies demonstrated that no significant survival difference between mechanical and bilologic valves (Brinkman, 2002;Thourani, 2011). Furthermore, several studies recommend biological valve instead of mechanical valve in patients on chronic dialysis (Lucke, 1997). Chronic renal failure is a known major risk factor for bleeding in patients with anticoagulant therapy (Lanefeld, 1989).…”

Section: Comorbiditiesmentioning

confidence: 99%

“…But, in ACC/AHA guideline updated in 2006, there is no recommendation for the choice of prosthetic valve type for these patients. Probably, this revision depends on new studies claimed similar results for both mechanical and biological prosthetic valve types for the patients on dialysis (Lucke, 1997;Kaplon, 2000;Herzog, 2002;Brinkman, 2002;. After these results, the criteria for the choice of valve type in the patients on dialysis shifted as those in patients without on dialysis.…”

Section: Wwwintechopencommentioning

confidence: 99%