2024-03-29T05:20:47Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00023538
2023-01-16T04:13:18Z
499:500:501
Early and Late Outcomes of Thoracic Aortic Surgery in Hemodialysis Patients
Hibino, Makoto
69906
Oshima, Hideki
69907
Narita, Yuji
69908
Abe, Tomonobu
69909
Mutsuga, Masato
69910
Fujimoto, L. Kazuro
69911
Tokuda, Yoshiyuki
69912
Terazawa, Sachie
69913
Ito, Hideki
69914
Usui, Akihiko
69915
Background: The number of cardiovascular surgeries among hemodialysis patients is increasing according to the growing population of hemodialysis patients; however, the clinical outcome has not yet been clarified, especially in thoracic aortic surgery. The purpose of this study was to assess the early and late outcomes of thoracic aortic surgery in hemodialysis patients. Methods: We retrospectively analyzed the outcomes of 700 consecutive open thoracic aortic surgeries from 2002 to 2014. We identified 21 patients receiving preoperative hemodialysis (group HD) and 679 patients not receiving preoperative hemodialysis (group N). The patients were predominantly male, had diabetes mellitus and cardiogenic shock, and had less hyperlipidemia and elective surgery in group HD. The early and late outcomes were compared between 21 patients in each group using a propensity-score matched analysis. Results: The hospital stay and intensive care unit stay were significantly longer in group HD even after matching. The 30-day mortality and inhospital mortality showed no significant differences, whereas the rate of postoperative pneumonia was significantly higher in group HD compared with the matched group N (p = 0.0067). The 1-year, 3-year, and 7-year survival rates in group HD were 73.4%, 45.7%, and 30.5%, respectively, which were significantly poorer than that of group N both in the prematched (p < 0.001) and matched analyses (p = 0.0027). Conclusions: Considering the various operative risks associated with hemodialysis patients, the early mortality rate is acceptable, even after the association with many respiratory complications. Although hemodialysis patients have a compromised prognosis after surgery, excessive hesitation to perform thoracic aortic surgery may be avoided.
journal article
Elsevier
2016-10
application/pdf
The Annals of Thoracic Surgery
4
102
1282
1288
http://dx.doi.org/10.1016/j.athoracsur.2016.03.073
http://hdl.handle.net/2237/25734
0008-6312
https://nagoya.repo.nii.ac.jp/record/23538/files/ATS-2015-525360v2-Hibino.pdf
eng
https://doi.org/10.1016/j.athoracsur.2016.03.073
© 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/