2020 Volume 53 Issue 2 Pages 61-69
A perioperative protocol that followed the JSDT guidelines for cardiac surgery in dialysis patients was developed to improve interprofessional collaboration and patient care. We evaluated the perioperative protocol and surgical complications at our hospital. The subjects were 128 patients who underwent cardiac surgery between January 2016 and December 2018, excluding those who underwent concomitant aortic surgery. The subjects were divided into two groups; i.e., into those who were (dialysis group) and were not (control group; i.e., non-dialysis group) on maintenance dialysis therapy. The dialysis and control group consisted of 29 and 99 patients, respectively. Aortic valve replacement and coronary artery bypass grafting were the most common forms of cardiac surgery, and they exhibited similar frequencies in both groups. There were 2 (7%) and 3 (3%) in-hospital deaths in the dialysis and control groups, respectively. The postoperative hospital stay was significantly longer in the dialysis group (30.7 days vs. 23.3 days), and the proportion of patients requiring unplanned extracorporeal circulation was significantly higher in the dialysis group (17% vs. 1%). However, among cases involving isolated coronary artery bypass grafting, the duration of the postoperative hospital stay and frequency of unscheduled extracorporeal circulation were comparable between the two groups. In valve operations involving dialysis patients, further examinations should be carried out in order to reduce the risk of unscheduled extracorporeal circulation and shorten the hospitalization period.
