Double Valve Replacement in a Dialysis Patient and Perioperative Management with the Continuous Hemodiafiltration / 日本心臓血管外科学会雑誌

ABSTRACT

The patient was a 44-year-old male, who had undergone hemodialysis for these 13 years. He underwent combined aortic and mitral valve replacement for aortic and mitral regurgitation due to infectious endocarditis. Operative findings included torn chorda of the mitral valve associated with perivalvular abscess and perforation of a non-coronary aortic cusp. Double valve replacement was performed with mechanical prosthetic valves. We used continuous hemodiafiltration (CHDF) for his perioperative renal management. Nafamostat mesilate was applied to the CHDF circuit as anti-coagulant therapy. Serum creatinin, urea nitrogen and potassium were maintained at the optimal level. CHDF was continued until the twelfth day after operation, and maintainace hemodialysis was re-started thereafter. CHDF is widely accepted for blood purification in the intensive care unit, and applied safely even in patients with unstable hemodynamic conditions. we considered that CHDF might have helped to avoid multiple organic failure in this case.