Mid-term results of surgical aortic valve replacement with bioprostheses in hemodialysis patients.
Int J Cardiol Heart Vasc
; 40: 101030, 2022 Jun.
Article
in En
| MEDLINE
| ID: mdl-35434259
ABSTRACT
Background:
Limited studies have assessed the factors affecting prognosis in hemodialysis (HD) patients who undergo surgical aortic valve replacement with a bioprostheses (SAVR-BP). This study aimed to evaluate the outcomes of HD patients who had undergone SAVR-BP for aortic stenosis (AS) and identify the risk factors for mortality.Methods:
This retrospective study included 57 HD patients who had undergone SAVR-BP for AS between July 2009 and December 2020. Multivariate logistic regression was used to predict factors associated with mid-term outcomes and death or survival. Kaplan - Meier curves were also generated for mid-term survival.Results:
The in-hospital mortality rate was 8.8%, and the 5-year mortality rate was 42.1%. The independent predictors of 5-year mortality were preoperative age (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.175-2.083, p = 0.002), hyperlipidemia (HR, 0.02; 95% CI, 0.002-0.297, p = 0.004), left ventricular diastolic diameter (HR, 1.74; 95% CI, 1.142-2.649, p = 0.010), left ventricular systolic diameter (HR, 0.61; 95% CI, 0.392-0.939, p = 0.025), and Japan SCORE (HR, 1.28; 95% CI, 1.052-1.563, p = 0.014). The postoperative predictors included intensive care unit stay (HR, 1.11; 95% CI, 1.035-1.194, p = 0.004) and albumin level (HR, 0.38; 95% CI, 0.196-0.725, p = 0.003).Conclusions:
The 5-year prognosis of HD patients undergoing SAVR may be improved by early diagnosis (before the occurrence of LV hypertrophy/enlargement) and nutritional management with oral intake to alleviate postoperative hypoalbuminemia.Registration number of clinical studies UMIN000047410.
95% CI, confidence interval; APACHE, Acute Physiology and Chronic Health Evaluation; AS, aortic stenosis; AXA, axillary artery; Af, atrial fibrillation; Aortic valve stenosis; Bioprostheses; CABG, coronary artery bypass graft; CP, cold blood cardioplegia; CPB, cardiopulmonary bypass; Dd, diastolic diameter; Ds, systolic diameter; ECMO, extracorporeal membrane oxygenation; HD, hemodialysis; HF, heart failure; HR, hazard ratio; Hemodialysis; IABP, intra-aortic balloon pumping; ICU, intensive care unit; LOS, low output syndrome; LV, left ventricular; LVEF, left ventricle ejection fraction; MACCE, major adverse cardiovascular and cerebrovascular events; MI, myocardial infarction; SAPS II, Simple Acute Physiology Score II; SAVR, surgical aortic valve replacement; SAVR-BP, SAVR with bioprostheses; SD, standard deviation; SOFA, Sequential Organ Failure Assessment; Surgical aortic valve replacement; TAVR, transcatheter aortic valve replacement
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Language:
En
Journal:
Int J Cardiol Heart Vasc
Year:
2022
Type:
Article
Affiliation country:
Japan