The Early Outcome of Aortic Valve Replacement Surgery for Dialysis Patients

Abstract

Objectives: Although the “mechanical valve” has historically been the popular choice to use as a prosthetic valve to treat dialysis patients requiring aortic value replacement (AVR) for aortic stenosis, bioprosthetic valves have also started to be considered for use, due to improvements of surgical outcomes observed through its technical improvements. In this study, we demonstrated our valve treatment strategy and investigated the early outcome to patients with dialysis.

Methods: 470 patients received an AVR between January 2009 and December 2012. We retrospectively reviewed and analyzed the clinical course of 32 patients with dialysis. 15 patients were male and 17 patients were female, with an average age of 72.4 ± 7.3 years (range: 57-86 years). The mean duration of hemodialysis was 8.7 years (range: 0.1-36 years). The mean Society of Thoracic Surgery score and Euro Score II was 17.0% and 8.9%, respectively. We used a bioprosthetic valve for patients aged >65 years.

Results: Mean observation period was 958 days. Regarding early mortality, there were 5 operative deaths within 30 days after operation (15.6%). There were 6 operative late deaths (20.7%). 1- and 3-year survivals in the bioprosthetic valve group were 68% and 46%, respectively. On the other hand, those in the mechanical valve group were 75% and 50%, respectively.

Conclusion: The use of bioprosthetic valves should be considered due to its added benefits and because there is no statistically significant difference on survival and valve-related complications between bioprosthetic and mechanical valve group.