Aggressive surgical strategy should be used for the treatment of thoracic aortic disease in patients with end-stage renal disease

Kazuma Okamoto, Hideyuki Shimizu, Toshihiko Ueda, Ryohei Yozu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Surgery for disease of the thoracic artery in patients with end-stage renal disease (ESRD) depending on hemodialysis (HD) tends to be avoided because of its high risk. However, considering that the average survival duration after HD induction is increasing, the adequacy of aggressive surgical treatment of thoracic aneurysms was investigated. Seventeen consecutive surgeries for 16 patients with ESRD with disease of the thoracic aorta performed between 1998 and 2008 were analyzed retrospectively. As an intraoperative renal replacement therapy, prior to 2001, HD was performed in six cases and, after 2002, continuous hemodiafiltration (CHDF) was performed in nine cases. In two cases, no renal replacement therapy was performed during surgery. No operative and hospital mortality occurred, despite challenging indications for surgery like emergency setting (52.5%), history of previous aortic surgery (41.2%) and aortic arch surgeries (58.8%). The five-year survival rate was 62.9%. Median follow-up was 38.8 months (1-117.6). According to this excellent outcome, surgical strategy for ESRD patients with disease of the thoracic aorta should be more aggressive than currently indicated because surgery can be safely performed by means of appropriate application of intraoperative HD or CHDF in order to give sufficient amounts of blood products and manage the water and electrolyte balance.

Original languageEnglish
Pages (from-to)384-388
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume12
Issue number3
DOIs
Publication statusPublished - 2011 Mar

Fingerprint

Thoracic Diseases
Aortic Diseases
Chronic Kidney Failure
Renal Dialysis
Thoracic Aorta
Hemodiafiltration
Renal Replacement Therapy
Therapeutics
Thoracic Arteries
Water-Electrolyte Balance
Hospital Mortality
Aneurysm
Emergencies
Thorax
Survival Rate
Survival

Keywords

  • Aortic aneurysm
  • Aortic dissection
  • Dialysis
  • End-stage renal disease
  • Thoracic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Aggressive surgical strategy should be used for the treatment of thoracic aortic disease in patients with end-stage renal disease. / Okamoto, Kazuma; Shimizu, Hideyuki; Ueda, Toshihiko; Yozu, Ryohei.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 12, No. 3, 03.2011, p. 384-388.

Research output: Contribution to journalArticle

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