Abstract
Objective : Chronic hemodialysis (HD) is a risk factor for coronary artery disease and aortic stenosis (AS), which is known to progress rapidly in HD patients. As HD patients are living longer in Japan, patients with both coronary artery disease and AS are increasing. However, patients undergoing combined aortic valve surgery and coronary artery bypass grafting (CABG) are widely considered to be at increased risk of poor outcomes. In this study, the outcomes of patients who underwent combined surgery for AS with CABG were examined.
Materials and Methods : Seventy-five HD patients who underwent isolated CABG (n = 64) or combined CABG with aortic valve surgery (n=18) were enrolled. The patients' background characteristics and clinical outcomes were analyzed retrospectively. Results : There were no differences in age, sex, or pre-operative comorbidities (hypertension, diabetes, or stroke) between the groups, except that hyperlipidemia was more prevalent in the isolated CABG group. There were no differences in postoperative stroke, respiratory failure, atrial fibrillation, or wound infection. Two patients in the isolated CABG group and one in the combination CABG with aortic valve surgery group died in hospital. Additionally, no differences were seen in cardiac mortality between the groups.
Conclusions : In HD patients, perioperative complications and long-term cardiac mortality did not differ between patients who underwent combined surgery for AS with CABG and those who had CABG surgery alone. Since the symptoms of AS progress rapidly in HD patients, combined surgery should be done without hesitation.
