15^th World Cardiac Surgery & Angiology Conference

Biography

Biography: Eyal Porat

Abstract

Background: The incidence of acute renal failure (ARF) after cardiac surgery and the risk of mortality associated with it continues to be high. The aim of this study was to evaluate if timing of cardiac catheterization influences the incidence of postoperative ARF.

Patients and methods: 408 patients undergoing cardiac surgery were prospectively evaluated. Mean age was 66+/-10 years, 22% were female, 38% diabetic, 69% had hypertension and 15% had peripheral vascular disease. Preoperative creatinine level and calculated creatinine clearance (CrCl) were 1.05+/-0.6 and 82+/- 27 respectively. Of the study population 39% underwent surgery within 24h of cardiac catheterization, 30% underwent surgery between the first and fifth day of catheterization, and 31% underwent surgery more than 5 days after cardiac catheterization. Endpoints were ARF, defined as a decrease in the calculated CrCl of 25% or more by the third postoperative day, and hospital mortality.

Results: 47% of patients who underwent surgery within 24h from cardiac catheterization have shown a decrease in calculated CrCl of 25% or more, as apposed to 29% in patients who underwent surgery between the 1^st and 5^th day after catheterization, and 23% in those who underwent surgery more than 5 days after catheterization (p=0.05). Mortality rate among patients who underwent surgery within 24h from catheterization was independently associated with acute renal failure ([OR]1.9, p=0.02). Preoperative calculated CrCl of less than 60ml/min and cardiac surgery within 24h from catheterization was independently related to hospital mortality ([OR]8, p=0.005).

Conclusion: Cardiac surgery performed within 24h from cardiac catheterization is a significant risk factor for acute renal failure, especially among patients with preoperative reduced renal function. Proper timing and patient selection is highly recommended.