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Open Heart Surgery in Patients with Chronic Renal Failure

Coronary and valvular heart diseases are the main causes of mortality and morbidity among the long-term survivors of chronic renal failure. Despite the additional risk factors, open heart surgical procedures have recently been attempted with high rates of success in some patients with chronic renal failure. Forty-three patients with chronic renal failure that have undergone open heart surgery are included in this study. Ten of the patients were female and the mean age was 53.1 ± 11.2 (26 to 71). Twenty-five patients underwent aortocoronary bypass operations and 18 others underwent heart valve replacements. In this group of patients, 38 (88.3%) were in the compensated retention stage of chronic renal failure and 5 (11.7%) were in the end stage. The decompensated chronic renal failure patients were on regular hemodialysis and continued to receive hemodialysis in the preoperative and postoperative period. Sixteen patients of the compensated chronic renal failure group needed hemodialysis postoperatively. Early mortality rate was 7.8% (n = 3). Mean stay in the intensive care unit after the operation was 3.0 ± 3.3 days (2 to 22 days). In the long-term follow-up 3 patients underwent successful renal transplantations within 9 to 18 months after the cardiac operations. Two of these patients had valve replacements and 1 had concomitant valve replacement and coronary artery bypass grafting prior to renal transplantation. We conclude that coronary angiography, catheterization, myocardial revascularization, and valve replacements can be safely performed and should be considered if indicated in chronic renal failure patients.