| Theme |
Cardioascular Diseases in Dialysis Patients -- Understanding, Treatment and Management |
| Title |
Cardiac surgery for chronic hemodialysis patients |
| Author |
Mikio Ninomiya |
Department of Cardiovascular Surgeiy, Graduate School of Medicine, University of Tokyo |
| Author |
Toshiya Ohtsuka |
Department of Cardiovascular Surgeiy, Graduate School of Medicine, University of Tokyo |
| Author |
Shinichi Takamoto |
Department of Cardiovascular Surgeiy, Graduate School of Medicine, University of Tokyo |
| [ Summary ] |
Care should be taken in relation to the various features of chronic hemodialysis patients to conduct cardiac surgery safely. Preoperatively, the influence of tissue calcification on surgical therapy, and the severity of complications such as arterial sclerosis and diabetes mellitus should be evaluated. Intraoperatively, surgeons must consider the tissue weakness or the ease of infection in hemodialysis patients, and conduct proper surgical procedures. Sufficient blood flow must be maintained, especially during cardiopulmonary bypass surgery. Postoperatively, CHDF is ideal because of its little influence on hemodynamics. The existence of shunt flow or high vascular wall permiability should be taken into consideration. |