Renal Data from the Arab World: Cardiac Surgery in Patients on Hemodialysis: Eight Years Experience of the Tunisian Military Hospital

End-stage renal disease (ESRD) is known to be an important risk factor for cardiac operations performed with cardiopulmonary bypass. We investigated the influence of preoperative status on perioperative mortality and morbidity. We retrospectively analyzed data from 26 patients with ESRD, who were on maintenance dialysis and underwent a cardiac surgical procedure between 2000 and 2007. Of them, 61.5% of the patients had isolated coronary artery bypass grafting (CABG) and 38.5% had replacement or reconstruction of one or two valves. The perioperative mortality rate was 26% with five deaths occurring in patients undergoing CABG procedure. We found CABG procedure, being female and left ventricular (LV) function 30% to be associated with a higher relative risk for perioperative death. In conclusion, our data suggest that both indications and referral for surgical intervention for coronary artery disease may be delayed in patients who have ESRD, contributing to the relatively high perioperative mortality.