Quantitative evaluation of superior mesenteric artery calcification in hemodialysis patients undergoing aortic valve rep
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ORIGINAL ARTICLE
Quantitative evaluation of superior mesenteric artery calcification in hemodialysis patients undergoing aortic valve replacement Shuhei Miura1 · Yoshihiko Kurimoto1 · Yutaka Iba1 · Ryushi Maruyama1 · Eiichiro Hatta1 · Akira Yamada1 Received: 3 February 2020 / Accepted: 31 March 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objective Postoperative acute mesenteric ischemia (AMI) in the long-term hemodialysis (HD) patients could be a disastrous complication leading to high mortality. The objective is to evaluate the association between the presence of superior mesenteric artery calcification (SMAC) and early and late outcomes after aortic valve replacement (AVR) in HD patients. Methods Between April 2003 and December 2018, the enrolled 46 HD patients (19 women; mean age 72 years) who underwent AVR for severe aortic valve stenosis were retrospectively reviewed. 25 patients (54.3%) who had severe calcifications of superior mesenteric artery (SMA) were defined as the SMAC group, and the calcification extent of SMA was evaluated on preoperative non-contrast CT using Agaston calcium score [calcification area ( cm2) × max CT value (HU)]. The operative outcomes were compared with those of the non-SMAC group comprising 21 patients (45.7%). Results The following factors in SMAC group were statistically higher compared with those of the non-SMAC group: age (73.6 ± 7.2 vs 69.3 ± 7.1 years; p = 0.04), celiac artery calcification (76.4% vs 17.6%; p
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