İzmir Atatürk Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği

Aim: Heart valve pathologies are rare in chronic renal failure (CRF) patients besides coronary atherosclerosis. Valve disfunctions are primarily due to ischemia, valvular calcification, A-V fistula and increased incidence of endocarditis secondary to dialysis. Methods: In both of our clinics, we performed 178 heart valve replacements between April 2001 and April 2003. 7 (3.9%) of them were CRF patients and 3 (1.6%) were in continuous hemodialysis programme. Remained 4 patients had CRF too, but they didn’t need hemodialysis because their glomerular filtration rate was over 30%. We evaluated the preoperative and postoperative followups, medical therapies and control results of these 7 CRF patients, with heart valve replacements. Results: We performed aortic valve replacement in 3, mitral valve replacement in 2 and coronary bypass plus mitral valve replacement in 2 patients. In the latter 2 cases, valve pathology was valve failure with ischemic nature. 4 patients were in class III and 3 were in class IV according to NYHA functional capacity classification. There wasn’t any mortality or important postoperative complications. During follow-up, symptoms and functional capacity were improved. We used mechanical valves in all patients. Conclusion: Cardiac surgical procedure in CRF patients has an acceptable morbidity and mortality and improves symptoms and quality of life. Also the procedure increases the renal transplantation chance and survival prolongs significantly. We suggest that mechanical valves must be preferred to bioprothesis when calcium metabolism disorders are taken into account.