Heart surgery with extracorporeal circulation in hemodialyzed patients with renal insufficiency

: The authors report 4 valvular replacements under cardiopulmonary bypass in chronic hemodialysis-dependent patients. The peri-operative management was the same in every case. The recent improvements of intensive care medicine amend this protocol. Considering the analysis of data from the literature and the results of our 4 valvular replacements these operations and coronary artery-bypass graft, can be scheduled with an acceptable risk in these patients. Because of the hemodynamic improvement secondary to the cardiac operation, which allows a better tolerance of hemodialysis, this surgery must not be delayed.