It is difficult that chronic heart failure (CHF) with CS 5 and preserved ejection fraction (HFpEF) are under control especially in the elder. In addition, chronic kidney disease (CKD) and severe tricuspid regurgitation (TR) complicates furthermore CHF in the elder. We experienced that three elderly CHF patients with CS5, CKD and severe TR could become stable by active introduction of hemodialysis (HD). The present cases consisted of 2 males and 1 female with averaged 78y.o. Their basic heart diseases were two operated congenital heart diseases and one ischemic heart disease. Their CHF were greater than NYHA III, refractory to ordinary intensive treatment, and caused frequent hospitalization. Before and After HD, averaged serum creatinine, LVEF, IVC diameter, and speculated PA pressure were 2.0 and 2.2 mg/dl, 53 and 49%, 27 and 24 mm, and 60 and 51 mmHg, respectively. After active introduction of HD their CHF became less than NYHA II and was prevented from hospitalization. Taken together, active introduction of HD may be effective in elderly CHF with CS 5, CKD and severe TR.
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