Incidence of postoperative acute kidney injury in patients with chronic kidney disease undergoing minimally invasive valve surgery

Background We hypothesize that minimally invasive valve surgery in patients with chronic kidney disease (CKD) is superior to a conventional median sternotomy. Methods We retrospectively analyzed 1945 consecutive patients who underwent isolated valve surgery. Included were patients with CKD stages 2...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2013-12, Vol.146 (6), p.1488-1493
Main Authors: Valdez, Gerson D., MD, Mihos, Christos G., DO, Santana, Orlando, MD, Heimowitz, Todd B., DO, Goldszer, Robert, MD, Lamas, Gervasio A., MD, Lamelas, Joseph, MD
Format: Article
Language:English
Subjects:
Acute Kidney Injury - epidemiology
Acute Kidney Injury - mortality
Acute Kidney Injury - therapy
Aged
Aged, 80 and over
Cardiac Surgical Procedures - adverse effects
Cardiac Surgical Procedures - mortality
Cardiothoracic Surgery
Chi-Square Distribution
Female
Florida - epidemiology
Health Resources - utilization
Heart Valve Diseases - epidemiology
Heart Valve Diseases - mortality
Heart Valve Diseases - surgery
Hospital Mortality
Humans
Incidence
Intensive Care Units
Length of Stay
Logistic Models
Male
Middle Aged
Minimally Invasive Surgical Procedures
Multivariate Analysis
Odds Ratio
Renal Insufficiency, Chronic - epidemiology
Renal Insufficiency, Chronic - mortality
Retrospective Studies
Risk Assessment
Risk Factors
Sternotomy - adverse effects
Sternotomy - mortality
Time Factors
Treatment Outcome
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Summary:Background We hypothesize that minimally invasive valve surgery in patients with chronic kidney disease (CKD) is superior to a conventional median sternotomy. Methods We retrospectively analyzed 1945 consecutive patients who underwent isolated valve surgery. Included were patients with CKD stages 2 to 5. In-hospital mortality, composite complication rates, and intensive care unit and total hospital lengths of stay of those who underwent a minimally invasive approach were compared with those who underwent a standard median sternotomy. Resource use was approximated based on intensive care unit and total hospital lengths of stay. Results There were 688 patients identified; 510 (74%) underwent minimally invasive surgery, and 178 (26%) underwent a median sternotomy. There was no significant difference in mortality. Minimally invasive surgery was associated with fewer composite complications (33.1% vs 49.4%; odds ratio, 0.5; P ≤ .001), shorter intensive care unit (48 [interquartile range {IQR}, 33-74] hours vs 71 [IQR, 42-96] hours; P  
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2013.06.034