Kitamura M, Yamasaki K, Takemura T, Takasawa A, Kawai A, Shikawa A, Endo M, Hashimoto A, Hayashi H, Koyanagi H
Nihon Kyobu Geka Gakkai Zasshi. 1989 Dec;37(12):2507-12.
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.
在过去六年中，11名慢性透析患者接受了心脏手术。其中6例患有冠状动脉疾病，3例患有瓣膜性心脏病，另外2例患有先天性心脏病。在这11名患者中，5例在术前和术后均成功维持持续性非卧床腹膜透析（CAPD）。其余6例患者在手术前接受血液透析治疗，心脏手术后接受间歇性腹膜透析或血液透析。9例在体外循环下进行了术中血液透析。有1例因低心排血量综合征早期死亡，2例患者在术后晚期死于脑出血。后两者均患有高血压，并在抗凝治疗下维持血液透析。其他8例情况良好，其中5例进行CAPD治疗。这些结果表明，对于患有高血压的慢性透析患者的心脏手术，应选择不进行抗凝和/或采用CAPD的手术方式。
