OBJECTIVE: Hemodialysis patients have an increased risk of hemorrhage compared to other patients. This study reports the frequencies of hemorrhage and its impact on the survival of hemodialysis patients after valve replacement. METHODS: A total of 77 consecutive dialysis patients who underwent prosthetic valve surgery from 1991 to 2011 were retrospectively reviewed. Their mean age was 65.8 ± 9.2 years. Forty-three patients (56%) were male. Fifty-nine patients (77%) had aortic valve replacement, and 23 patients (30%) had mitral valve replacement. Bioprosthetic valves were used in 17 patients (22%). RESULTS: There were seven in-hospital mortalities (9.1%). The overall estimated Kaplan-Meier survival after 3, 5 and 7 years was 66.6 ± 5.6, 51.1 ± 6.3 and 34.4 ± 6.8%, respectively. Seventeen (22%) bleeding events were observed (5.9% per patient-years) in the follow-up period. Six of the nine patients with cerebral hemorrhages and two of the six with gastrointestinal hemorrhages died. There were no differences in the frequencies of hemorrhage between the patients treated with bioprostheses and mechanical valves. CONCLUSIONS: This study found that 22% of dialysis patients had hemorrhagic events after valve replacement, and approximately half of them died. Particularly, cerebral hemorrhage was fatal and two thirds of the patients died. So we should meditate the methods to reduce hemorrhage. Therefore, new methods to reduce the risk of hemorrhage are urgently needed.
OBJECTIVE: Hemodialysis patients have an increased risk of hemorrhage compared to other patients. This study reports the frequencies of hemorrhage and its impact on the survival of hemodialysis patients after valve replacement. METHODS: A total of 77 consecutive dialysis patients who underwent prosthetic valve surgery from 1991 to 2011 were retrospectively reviewed. Their mean age was 65.8 ± 9.2 years. Forty-three patients (56%) were male. Fifty-nine patients (77%) had aortic valve replacement, and 23 patients (30%) had mitral valve replacement. Bioprosthetic valves were used in 17 patients (22%). RESULTS: There were seven in-hospital mortalities (9.1%). The overall estimated Kaplan-Meier survival after 3, 5 and 7 years was 66.6 ± 5.6, 51.1 ± 6.3 and 34.4 ± 6.8%, respectively. Seventeen (22%) bleeding events were observed (5.9% per patient-years) in the follow-up period. Six of the nine patients with cerebral hemorrhages and two of the six with gastrointestinal hemorrhages died. There were no differences in the frequencies of hemorrhage between the patients treated with bioprostheses and mechanical valves. CONCLUSIONS: This study found that 22% of dialysis patients had hemorrhagic events after valve replacement, and approximately half of them died. Particularly, cerebral hemorrhage was fatal and two thirds of the patients died. So we should meditate the methods to reduce hemorrhage. Therefore, new methods to reduce the risk of hemorrhage are urgently needed.
Authors: Raphaelle L Dumaine; Gilles Montalescot; Ph Gabriel Steg; E Magnus Ohman; Kim Eagle; Deepak L Bhatt Journal: Am Heart J Date: 2009-07 Impact factor: 4.749
Authors: Ju-Yeh Yang; Tsung-Chun Lee; Maria E Montez-Rath; Jane Paik; Glenn M Chertow; Manisha Desai; Wolfgang C Winkelmayer Journal: J Am Soc Nephrol Date: 2012-01-19 Impact factor: 10.121
Authors: J Matthew Toole; Martha R Stroud; John M Kratz; Arthur J Crumbley; Fred A Crawford; John S Ikonomidis Journal: J Heart Valve Dis Date: 2006-05
Authors: Vinod H Thourani; Eric L Sarin; W Brent Keeling; Patrick D Kilgo; Robert A Guyton; Ameesh B Dara; John D Puskas; Edward P Chen; William A Cooper; J David Vega; Cullen D Morris; Omar M Lattouf Journal: Ann Thorac Surg Date: 2011-02-25 Impact factor: 4.330
Authors: Thierry Bourguignon; Eric Bergöend; Alain Mirza; Grégoire Ayegnon; Paul Neville; Michel R Aupart; Michel Marchand Journal: J Heart Valve Dis Date: 2011-11
Authors: William T Brinkman; Willis H Williams; Robert A Guyton; Ellis L Jones; Joseph M Craver Journal: Ann Thorac Surg Date: 2002-07 Impact factor: 4.330
Authors: Kevin S Kim; Emilie P Belley-Côté; Saurabh Gupta; Arjun Pandey; Ali Alsagheir; Ahmad Makhdoum; Graham McClure; Brooke Newsome; Sophie W Gao; Matthias Bossard; Tetsuya Isayama; Yasuhisa Ikuta; Michael Walsh; Amit X Garg; Gordon H Guyatt; Richard P Whitlock Journal: Can J Surg Date: 2022-07-12 Impact factor: 2.840