Renal Transplantation in a Patient with Uremic Cardiomyopathy Resulting in Marked Improvement of Cardiac Function
10.4326/jjcvs.38.160
- VernacularTitle:腎移植は尿毒症性心の低心機能を著明に改善する
- Author:
Taisuke Nakayama
;
Hirotsugu Kurobe
;
Takaki Hori
;
Kazuma Maisawa
;
Hiroshi Ishitoya
;
Hitoshi Sogabe
;
Itsuo Katoh
;
Tetsuya Kitagawa
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2009;38(2):160-164
- CountryJapan
- Language:Japanese
-
Abstract:
A 71-year-old man who had been on peritoneal dialysis for 6 years was referred to our hospital for renal transplantation from a living donor. Preoperative echocardiography revealed diffuse severe hypokinesis, a left ventricular ejection fraction (LVEF) of 25%, and a pedicled floating mass in the right atrium. He had not exhibited positive symptoms of active endocarditis or metastatic malignant tumor, and the causes of cardiomyopathy seemed to be uremic and/or ischemic factors. Renal transplantation was postponed, and the extirpation of the mass in the right atrium was scheduled. LVEF improved to 48% 2 months following the induction of hemodialysis before the cardiac operation. Pathohistological findings of the extirpated intra-atrial mass showed sphachelus and fibrotic thrombus, which meant asymptomatic healed infective endocarditis. He recovered uneventfully, and underwent a living renal transplantation from living donor 5 months after the cardiac operation. LVEF further improved better to 56%, and his performance status was remarkably improved. These results imply that renal transplantation and hemodialysis in peritoneal dialysis patients with uremic cardiomyopathy can achive improvement of cardiac function and enable a safe cardiac operation.
