Thorac Cardiovasc Surg 2013; 61(01): 022-028
DOI: 10.1055/s-0032-1331841
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Cardiac Surgery in Dialysis-Dependent Patients: Impact of Gender on Early Outcome in Single-Center Experience with 204 Consecutive Cases

Oliver Deutsch
1   Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany
,
Kyriakos Spiliopoulos
2   Department of Thoracic and Cardiovascular Surgery, University of Thessaly School of Medicine, Larissa, Greece
,
Theodor Kiask
1   Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany
,
Elpiniki Katsari
3   Klinik für Herz- Thorax- und Gefäßchirurgie, Klinikum Karlsburg, Karlsburg, Germany
,
Nathalie Rippinger
1   Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany
,
Walter Eichinger
1   Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany
,
Birgitte Gansera
1   Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany
› Author Affiliations
Further Information

Publication History

15 May 2012

23 October 2012

Publication Date:
10 January 2013 (online)

Abstract

Background This study evaluates the impact of gender in dialysis-dependent patients undergoing cardiac surgery.

Methods We retrospectively identified 204 dialysis-dependent patients (68.6% male, aged 66.6 ± 9.9 years) with end-stage renal disease undergoing cardiac surgery and compared them to a propensity-score-pair-matched control collective.

Results A 30-day mortality was 13.2% (14/106) for coronary artery bypass grafting (CABG), 19.3% (6/31) for aortic valve replacement (AVR), and 23.8% (16/67) for combined procedures. Postoperative chest tube output was significantly higher in men (1,007 ± 946 mL) versus women (687 ± 598 mL, p = 0.014). Compared with a propensity-score-pair-matched control collective of 204 patients, we identified significant differences in terms of 30-day mortality: overall mortality revealed 17.6 versus 4.6% (p = 0.0001), 13.2 versus 3.4% (p = 0.014) for CABG, 19.3 versus 0% (p = 0.051) for AVR, and 23.8 versus 9.1% (p = 0.02) for combined procedures.

Conclusion Multivariate analysis identified preoperative myocardial infarction, prolonged extracorporeal circulation time, operation time, and surgical reexploration as independent predictors of 30-day mortality. There was a higher occurrence of bleeding complications in men that remained significant even after correction for body surface area.