Skip to main content
SpringerLink
Log in

Aortic valve prosthesis selection in dialysis patients based on the patient’s condition

  • Original Article
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

Previous studies have examined outcomes in dialysis patients undergoing cardiac surgery. However, only a few studies have solely focused on outcomes after aortic valve replacement (AVR). This study aimed to clarify independent predictors of the long-term survival of dialysis patients with AVR and to determine whether a mechanical valve or bioprosthesis is suitable based on the patient’s condition. A total of 38 consecutive dialysis patients who underwent AVR at our institute were reviewed (mean age 69.1 ± 9.4 years). There were 23 bioprostheses and 15 mechanical valve replacements. The operative mortality and the long-term survival were not different between the bioprosthesis and the mechanical valve group (13.0 vs. 13.3%). The significant multivariate predictors for long-term survival were concomitant coronary artery bypass grafting (CABG) and prosthesis size. Valve types and age at operation did not affect long-term survival. Five-year survival of patients with small prosthetic valves and concomitant CABG was 0%. When the patient’s quality of life is taken into account, it may be appropriate to use a bioprosthesis in a dialysis patient with a small annulus and concomitant CABG even if the patient is young.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. The Japanese Society for Dialysis Therapy. An overview of regular dialysis treatment in Japan as of Dec. 31, 2009. http://docs.jsdt.or.jp.

  2. Thourani VH, Sarin EL, Keeling B, Kilgo PD, Guyton RA, Dara AB, Puskas JD, Chen EP, Cooper WA, Vega JD, Morris CD, Lattouf OM. Long-term survival for patients with preoperative renal failure undergoing bioprosthetic or mechanical valve replacement. Ann Thorac Surg. 2011;91:1127–34.

    Article  PubMed  Google Scholar 

  3. Chan V, Jamieson RE, Fleisher AG, Denmark D, Florence C, Germann E. Valve replacement surgery in end-stage renal failure: mechanical prostheses versus bioprosthesis. Ann Thorac Surg. 2006;81:857–62.

    Article  PubMed  Google Scholar 

  4. Brinkman WT, Williams WH, Guyton RA, Jones EL, Craver JM. Valve replacement in patients on chronic renal dialysis: implications for valve prosthesis selection. Ann Thorac Surg. 2002;74:37–42.

    Article  PubMed  Google Scholar 

  5. Horst M, Uwe M, Hoerstrup SP, Suedkamp M, de Vivie ER. Cardiac surgery in patients with end-stage renal disease: 10-year experience. Ann Thorac Surg. 2000;69:96–101.

    Article  PubMed  CAS  Google Scholar 

  6. Cooper WA, O’Brien SM, Thourani VH, Guyton RA, Bridges CR, Szczech LA, Petersen R, Peterson ED. Impact of renal dysfunction on outcomes of coronary artery bypass surgery: results from the Society of Thoracic Surgeons National Adult Cardiac Database. Circulation. 2006;113:1063–70.

    Article  PubMed  Google Scholar 

  7. Tanaka K, Tajima K, Takami Y, Okada N, Terazawa S, Usui A, Ueda Y. Early and late outcomes of aortic valve replacement in dialysis patients. Ann Thorac Surg. 2010;89:65–71.

    Article  PubMed  Google Scholar 

  8. Herzog CA, Ma JZ, Collins AJ. Long-term survival of dialysis patients in the United States with prosthetic heart valves: should the ACC/AHA practice guidelines on valve selection be modified? Circulation. 2002;105:1336–41.

    Article  PubMed  Google Scholar 

  9. Bonow RO, Carabello B, de Leon AC Jr, Edmunds LH, Fedderly BJ, Freed MD, Gaasch WH, McKay CR, Nishimura RA, O’Gara PT, O’Rourke RA, Rahimtoola SH, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Gibbons RJ, Russell RO, Ryan TJ, Smith SC Jr. Guidelines for the management of patients with valvular heart disease: Executive Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Valvular Heart Disease). Circulation. 1998;98:1949–84.

    Google Scholar 

  10. Fann JI, Miller DC, Moore KA, Mitchell RS, Oyer PE, Stinson EB, Robbins RC, Shumway NE. Twenty-year clinical experience with porcine bioprostheses. Ann Thorac Surg. 1996;62:1301–11.

    Article  PubMed  CAS  Google Scholar 

  11. Solymar L, Rao PS, Mardini MK, Fawzy ME, Guinn G. Prosthetic valves in children and adolescents. Am Heart J. 1991;121:557–68.

    Article  PubMed  CAS  Google Scholar 

  12. Fishbein MC, Gissen SA, Collins JJ Jr, Barsamian EM, Cohn LH. Pathologic findings after cardiac valve replacement with glutaraldehyde-fixed porcine valves. Am J Cardiol. 1977;40:331–7.

    Article  PubMed  CAS  Google Scholar 

  13. Lamberti JJ, Wainer BH, Fisher KA, Karunaratne HB, Al-Sadir J. Calcific stenosis of the porcine heterograft. Ann Thorac Surg. 1979;28:28–32.

    Article  PubMed  CAS  Google Scholar 

  14. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP Jr, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT, O’Rourke RA, Otto CM, Shah PM, Shanewise JS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC. 2006;48:e1–148.

  15. Yamamura M, Mitsuno M, Tanaka H, Kobayashi Y, Ryomoto M, Nishi H, Fukui S, Tsujiya N, Kajiyama T, Miyamoto Y. Risk-factors for open heart surgery in hemodialysis patients. Gen Thorac Cardiovasc Surg. 2009;57:235–8.

    Article  PubMed  Google Scholar 

  16. Edwards FH, Peterson ED, Coombs LP, DeLong ER, Jamieson WR, Shroyer ALW, Grover FL. Prediction of operative mortality after valve replacement surgery. J Am Coll Cardiol. 2001;37:885–92.

    Article  PubMed  CAS  Google Scholar 

  17. Hirose H, Amano A, Takahashi A, Takanashi S. Coronary artery bypass grafting in patients on chronic hemodialysis: diabetic nephropathy versus nondiabetic nephropathy. Artif Organs. 2002;26:794–801.

    Article  PubMed  Google Scholar 

  18. Blais C, Dumensnil JG, Baillot R, Simard S, Doyle D, Pibarot P. Impact of prosthesis-patient mismatch on short term mortality after aortic valve replacement. Circulation. 2003;108:983–8.

    Article  PubMed  Google Scholar 

  19. Walther T, Rastan A, Falk V, Lehmann S, Garbade J, Funkat AK, Mohr FW, Gummert JF. Patient prosthesis mismatch affects short- and long-term outcome after aortic valve replacement. Eur J Cardiothorac Surg. 2006;30:15–9.

    Article  PubMed  Google Scholar 

  20. Losi MA, Memoli B, Contaldi C, Barbati G, Del Prete M, Betocchi S, Cavalloro M, Carpinella G, Fundaliotis A, Parrella LS, Parisi V, Guida B, Chiariello M. Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis. Nephrol Dial Transplant. 2010;25:1950–4.

    Article  PubMed  Google Scholar 

  21. Foley RN, Parfrey PS. Cardiac disease in chronic uremia: clinical outcome and risk factors. Adv Ren Replace Ther. 1997;4:234–48.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan

    Shinya Fukui, Mitsuhiro Yamamura, Masataka Mitsuno, Hiroe Tanaka, Masaaki Ryomoto & Yuji Miyamoto

Authors
  1. Shinya Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitsuhiro Yamamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masataka Mitsuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroe Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masaaki Ryomoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuji Miyamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Shinya Fukui or Yuji Miyamoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fukui, S., Yamamura, M., Mitsuno, M. et al. Aortic valve prosthesis selection in dialysis patients based on the patient’s condition. J Artif Organs 15, 162–167 (2012). https://doi.org/10.1007/s10047-012-0631-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-012-0631-y

Keywords

Search

Navigation