Clin Res Cardiol 96:Suppl 2 (2007)

P375 - Long term survival of dialysis patients requiring valve surgery independent of type of prosthesis implanted
P. Hölzl1, J. Easo1, M. Horst1, K. Kronberg2, R. Motz3, O. Dapunt1
1Klinik für Herzchirurgie, Klinikum Oldenburg gGmbH, Oldenburg; 2Klinik für Kardiologie, Klinikum Oldenburg gGmbH, Oldenburg; 3Klinik für Kinderkardiologie, Klinikum Oldenburg gGmbH, Oldenburg;
Introduction: Valve surgery in patients suffering under end stage renal disease remains controversial with guidelines recommending replacement with mechanical prostheses due to presumed accelerated calcification and structural valve deterioration of xenografts. We performed a long term followup of our patients to determine the validity of this recommendation.
Materials and Methods: Information obtained from a computer based valve replacement database with telephone interviews and patient charts were reviewed for followup data.
Results: Between 1999 and 2005 56 dialysis patients underwent valve replacement. Of these patients 33 received mechanical prostheses (25 aortic, 10 mitral, 1 tricuspid) and 23 received tissue valves (18 aortic, 7 mitral, 1 pulonary). The mean followup for the mechanical and tissue valve groups were 20.4±20.6 months and 18.2±19,8 months respectively. Freedom from reoperation at 4 years was 97%/96%. No siginificant differences in freedom from thrombembolism (mech 1/33, bio 0/23), haemorrhage (mech 1/33, bio 1/23), valve related mortality and morbidity could be discerned at 4 years.
Conclusion: Dialysis patients continue to represent a high risk patient collective, valve surgery can be performed with acceptable operative results. Data analysis demonstrates the long term survival to be poor, irrespective of the type of valve prosthesis implanted. Incidences of thrombembolism, bleeding and valve related mortality and morbidity were similar in both groups.