[Peri-operative management and follow-up outcomes of cardiac surgery in dialysis-dependent patients with end stage renal disease].

Objective: To summarize the perioperative management experience of patients with end-stage renal diseases (ESRD) undergoing cardiac surgery and the follow-up outcomes.

Methods: From September 2004 to February 2012, 18 dialysis-dependent patients with ESRD received cardiac surgery in Department of Cardiac Surgery, Peking University First Hospital. A series of methods were employed to maintain water-electrolyte and acid-base balance and coagulation function. We followed up the patients by clinic service or telephone.

Results: The spectra of surgical interventions included isolated coronary artery bypass graft (CABG, n=13), isolated valve replacement (VR, n=2) and concomitant CABG and VR (n=3). Of the 18 patients, 3 died within the Peri-operative period and 15 recovered and were discharged. The follow up period was 6-91 months [(27.6±27.5) months]. Within the follow up period, 2 patients died (66th month and 76th month), non-fatal complications occurred in 3 patients. Cardiac functions of the survived patients were good according to the New York Heart Association (NYHA) classification, 4 of them were within NYHA class I and 9 within NYHA class II.

Conclusion: Dialysis-dependent patients with end-stage renal diseases are a high risk group receiving cardiac surgery, but a comprehensive Peri-operative management of water-electrolyte and acid-base balance and coagulation function could yield a better outcome.