Introduction: The surgical management of abdominal aortic aneurysm in patients with chronic renal insufficiency (CRI) undergoing hemodialysis raises increasing difficulties due to tissue fragility as bleeding and infection susceptibility.
Purpose: To evaluate the surgical results in patients undergoing hemodialysis submitted to elective repair of the abdominal aortic aneurysm (AAA).
Patients and methods: Between March 1982 and January 2008, 942 patients undergoing elective repair of abdominal aortic aneurysm (AAA), being 8 patients (0,8%) in hemodialysis program. The mean age was 61,9+/-3,5 years, six men (75%). The patients were in hemodialysis program in median time of 21,5 months before surgery. Demographics and surgical data were analysed as the perioperative morbidity and mortality rates and causes of late deaths.
Results: The mean of operative time was 224,4+/-66 minutes, and blood loss was 812+/-233,12 mL. Major perioperative complications occurred in two patients (25%) and were due to instable angina in one patient and a fatal respiratory infection in another, mortality rate was 12,5%. Median follow up of the survival patients was 25,5 months (ranged 2 to 168 months). Two deaths were noticed during the follow up period, due to myocardial infarction in both cases.
Conclusions: Although the lower number of patients, we conclude that the AAA repair in patients undergoing hemodialysis can be performed with acceptable mortality and morbidity rates and long term survival.