Beating Heart Valve Surgery Using Stentless Xenografts as a Surgical Alternative for Patients with End-Stage Renal Failure

Introduction

Patients suffering from end-stage renal disease are an inhomogeneous high-risk group with substantial perioperative mortality and morbidity when undergoing cardiac surgical procedures [1], [2], [3]. Myocardial ischemia, reperfusion injury and myocardial edema are a few of the deleterious consequences of the traditional use of cardioplegic arrest when performing valve surgery, irrespective of type of cardioplegia used [4], [5], [6], [7]. Novel operative techniques are required to reduce these induced perioperative risks. Clinical studies in the past have demonstrated the efficacy of beating heart valve surgery in the high-risk patient using retrograde, antegrade or combined coronary perfusion with warm oxygenated blood [8], [9]. We chose to combine the superior hemodynamic profile of stentless xenografts and the concept of performing valve replacement on the empty beating heart with a continuous antegrade application of oxygenated blood in two chronic hemodialysis patients.

References

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