| Theme |
Cardiovascular Complications in Chronic Dialysis Patients -- Are They Inevitable? |
| Title |
Valvular disease in dialysis patients -- key points from surgeon's view point |
| Author |
Hiroshi Nishida |
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University |
| [ Summary ] |
The major valvular involvements in dialysis patients are stenotic lesions (mainly aortic) caused by calcification of the annulus and leaflet as well as endocarditis. In aortic stenosis, not uncommonly, small annulus requires a small size artificial valve with annular enlargement. Although the use tissue valve is becoming popular, mechanical valves are still the valve of choice because of better long-term durability especially in dialysis patients with impaired calcium metabolism. Early and late results after valve surgery are poor, and meticulous intensive care after operations along with light anticoagulation therapy may be a key factor for improvement. |