Perioperative management and impact of preoperative renal dysfunction on short-term survival for patients undergoing valve replacement
10.3760/cma.j.issn.1001-4497.2013.04.003
- VernacularTitle:肾功能不全患者瓣膜置换术后近期疗效与围手术期处理
- Author:
Jian LIU
;
Yizhou YE
;
Min YU
;
Sheng SHI
;
Zhongxiang YUAN
- Publication Type:Journal Article
- Keywords:
Heart valve prosthesis;
Renal dysfunction;
Perioperative care
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2013;(4):200-203
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the experience of perioperative management and effect of valve replacement combined with renal dysfunction.Methods 536 cases of valve replacement.According to preoperative glomerular filtration rate(GFR),renal dysfunction was classified as normal in 322 cases,mild in 162,moderate in 40 and severe in 12.Logistic regression analysis was used to assess the effect of preoperative renal dysfunction on operative mortality and morbidity.Results Patients with a lower GFR were older and more likely to have hypertention.They also tended to have larger left ventricular end-diastolic diameter and worse left ventricular ejection factor.Operative mortality rose inversely with declining renal function,from 2％ for those with normal renal function to 17％ for patients with severe renal dysfunction.Renal dysfunction was significantly associated with a large blood transfusions,re-intubation,longer mechanical ventilation,intensive care unit stay and hospital stay.Conclusion Preoperative renal dysfunction is an important factor of postoperative mortality and morbidity for valve replacement.We must pay more attention to perioperative management.
