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

研究成果: Article査読

4 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)384-388
ページ数5
ジャーナルInteractive cardiovascular and thoracic surgery
12
3
DOI
出版ステータスPublished - 2011 3

ASJC Scopus subject areas

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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