PMID- 8147642
OWN - NLM
STAT- MEDLINE
DCOM- 19940429
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 57
IP  - 3
DP  - 1994 Mar
TI  - Cardiac operations in patients with end-stage renal disease.
PG  - 691-6
AB  - Factors influencing the survival of 35 consecutive patients in end-stage renal 
      disease who required 40 open heart surgical procedures over the past 8 years were 
      studied. The mean age in these patients was 57.7 +/- 3 years (range, 32 to 77 
      years); 74.3% of the patients were male; and the average duration of hemodialysis 
      was 3.6 +/- 0.6 years. Twenty-nine myocardial procedures (20 of 29 for unstable 
      angina), six valve replacements, and five combined procedures were performed. The 
      actuarial survivals at 1 and 3 months, and at 1, 5, and 8 years were 90%, 85%, 
      76%, 55%, and 43%, respectively. Based on the results of univariate analysis, the 
      most significant predictor of both early and late mortality was New York Heart 
      Association (NYHA) class IV congestive heart failure. The 5-year survival in the 
      patients 60 years and older was less favorable than that in patients younger than 
      60 years (45% versus 63%) (p < 0.05). The 5-year survival in the patients in NYHA 
      class IV was only 27%, as compared to 63% in the patients in class II or III (p < 
      0.001). All survivors have remained free of angina and 19 of the 21 survivors 
      showed an improvement in their NYHA class. Four patients under 40 years of age 
      have subsequently been able to undergo renal transplantation. Overall, these 
      results justify proceeding with an open heart surgical procedure in dialysis 
      patients, when needed, but before the onset of congestive heart failure.
FAU - Kaul, T K
AU  - Kaul TK
AD  - Department of Cardiac Surgery, Baptist Medical Center-Princeton, Birmingham, 
      Alabama 35211.
FAU - Fields, B L
AU  - Fields BL
FAU - Reddy, M A
AU  - Reddy MA
FAU - Kahn, D R
AU  - Kahn DR
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Analysis of Variance
MH  - Female
MH  - Heart Diseases/complications/mortality/*surgery
MH  - Heart Failure/surgery
MH  - Heart Valve Prosthesis/mortality
MH  - Humans
MH  - Kidney Failure, Chronic/*complications/therapy
MH  - Male
MH  - Middle Aged
MH  - Myocardial Revascularization/mortality
MH  - Renal Dialysis
MH  - Retrospective Studies
MH  - Survival Rate
EDAT- 1994/03/01 00:00
MHDA- 1994/03/01 00:01
CRDT- 1994/03/01 00:00
PHST- 1994/03/01 00:00 [pubmed]
PHST- 1994/03/01 00:01 [medline]
PHST- 1994/03/01 00:00 [entrez]
AID - 0003-4975(94)90569-X [pii]
AID - 10.1016/0003-4975(94)90569-x [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1994 Mar;57(3):691-6. doi: 10.1016/0003-4975(94)90569-x.