An increasing number of patients who require maintenance hemodialysis have been subjected to open heart surgery in recent years. The pre- and post-operative care for these HD patients appears to be extremely important.
We have evaluated the clinical course of 25 patients with chronic HD who were admitted to our hospital and had open heart surgery within the past 5 years from July, 1988 through June, 1993, with specific attention to postoperative progress, clinical condition and outcome.
The following results were obtained: 1) 22 out of 25 patients were suffering from ischemic heart disease. 2) HF was performed during the coronary bypass operation, followed by HD on the day after surgery. 3) Only one patient required combined CVVH and ECUM because of difficulties with HD after the surgery. 4) Two patients died of arrhythmia and sepsis due to anterior mediastinitis, respectively.
In conclusion, open heart surgery can be performed safely in patients with chronic HD, when they are closely evaluated before and after surgery. In our present study, 24 out of 25 patients received maintenance HD in the postoperative period, and patients with chronic HD were able to resume HD without difficulty.