Impact of dialysis in patients undergoing bioprosthetic aortic valve replacement
| Autor: | Shinichi Tsumaru, Jun Iida, Yoshiharu Soga, Yuki Wada, Yuki Kuroda, Yumeka Tamai, Takashi Fukushima, Atsushi Nagasawa, Akira Marui, Yoshio Arai, Ryoko Arakaki |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Regurgitation (circulation) Prosthesis Design Aortic valve replacement Renal Dialysis Medicine Humans Dialysis Retrospective Studies Bioprosthesis Heart Valve Prosthesis Implantation Adult Cardiac business.industry Incidence (epidemiology) Retrospective cohort study Aortic Valve Stenosis medicine.disease Surgery Stenosis Treatment Outcome Aortic Valve Heart Valve Prosthesis Propensity score matching Hemodialysis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interact Cardiovasc Thorac Surg |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES To determine the incidence of bioprosthetic structural valve deterioration in dialysis patients undergoing aortic valve replacement compared to that in patients without dialysis. METHODS This single-centre retrospective observational study included 1159 patients who underwent aortic valve replacement using bioprosthetic valves for aortic stenosis and/or regurgitation at our institution between 2007 and 2017 [patients with dialysis (group D, n = 134, 12%) or without dialysis (group N, n = 1025, 88%)]. To adjust for potential differences between groups in terms of initial preoperative characteristics or selection bias, a propensity score analysis was conducted. The final sample that was used in the comparison included 258 patients, as follows: 129 patients with dialysis (group D) and 129 patients without dialysis (group N). The cumulative incidences of all-cause death, cardiac death and moderate or severe structural valve deterioration were estimated using the Kaplan–Meier method. RESULTS Operative mortality was significantly higher in group D than group N (9% vs 0%, P = 0.001). Kaplan–Meier analysis revealed that in group D, the incidence was significantly higher for all-cause death (P CONCLUSIONS The incidence of structural valve deterioration in dialysis patients undergoing aortic valve replacement was higher than that in patients without dialysis. Bioprosthetic valves should be carefully selected in dialysis patients undergoing aortic valve replacement. |
| Databáze: | OpenAIRE |
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