[Cardiac surgery in chronic dialysis patients: usefulness of continuous ambulatory peritoneal dialysis (CAPD)].

Eleven chronic dialysis patients underwent cardiac surgery in the past six years. Six of these cases had coronary artery disease, three had valvular heart disease and the other two had congenital heart disease. Of those 11 patients, 5 cases were successfully maintained on CAPD in the pre- and post-operative period. The remaining 6 patients were treated with hemodialysis before the operation and received intermittent peritoneal dialysis or hemodialysis following cardiac surgery. Intraoperative hemodialysis was carried out in 9 cases under cardiopulmonary bypass. There was one early death of low cardiac output syndrome, and two patients died of brain hemorrhage in the late post-operative period. Both of the latter two had hypertension and were maintained on hemodialysis under anticoagulant therapy. The other 8 are doing well and 5 of them are on CAPD. These results suggest that the procedure without anti-coagulation and/or CAPD should be chosen for the cardiac operation of chronic dialysis patients with hypertension.