AI Article Synopsis
- The study assessed cardiovascular surgery outcomes in 82 patients with non-dialysis-dependent chronic renal failure (CRF), focusing on different surgical types (valvular surgery, CABG, and combined surgery).
- It found that CABG patients had shorter procedure times, less blood usage, and shorter recovery periods, but early and late mortality rates varied across groups, with combined surgery showing higher late mortality.
- Key factors influencing mortality included patient age, prior cerebrovascular events, and certain preoperative lab values, indicating that patient characteristics were more crucial than surgery type for determining survival outcomes.
Article Abstract
Background: We evaluated the results of different types of cardiovascular surgery in patients with chronic renal failure (CRF) (serum creatinine ≥2 mg/dL) who were not dialysis-dependent.
Methods: Eighty-two patients who presented with non-dialysis-dependent CRF were retrospectively evaluated. Patients in Group 1 (n = 12) underwent valvular surgery, those in Group 2 (n = 58) underwent coronary artery bypass grafting (CABG), and those in Group 3 (n = 12) underwent combined CABG and valvular surgery.
Results: The demographics were similar among the groups. Cardiopulmonary bypass and aortic cross-clamping times were shorter (P < .01), the use of blood and blood products was less, and the mechanical ventilation time and hospital stay were shorter in Group 2 in comparison to the other groups (P < .01). There were 4 (6.9%) early mortalities in Group 2. Late mortalities occurred in 4 (33.3%), 16 (27.6%), and 6 (50%) patients from Groups 1, 2, and 3, respectively. Cox regression analysis revealed that age, the presence of a preoperative cerebrovascular accident, the presence of a left main coronary lesion, preoperative blood urea nitrogen level, and the use of blood and blood products were independent risk factors for early mortality. High Euroscore, cerebrovascular accident, the use of platelet suspension, longer ventilation support times, and combined CABG and valvular surgery were independent risk factors for late mortality.
Conclusions: Morbidity and survival seemed to be more dependent on preoperative patient characteristics than the type of surgery in this group of patients. Combined CABG and valvular surgery was a risk factor for late mortality.
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| http://dx.doi.org/10.1532/HSF98.20101161 | DOI Listing |
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