Cardiac surgery in cirrhotic patients: results and evaluation of risk factors

Child–Pugh Versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis

“…The characteristics of the 119 papers were shown in Table 1 . The countries included Austria (n = 1), 11 Belgium (n = 2), 38 , 96 China (n = 26), 20 , 21 , 27 , 30 , 31 , 53 – 55 , 59 , 60 , 74 , 84 , 102 , 109 , 112 , 113 , 117 , 119 – 121 , 123 – 128 Cuba (n = 1), 47 Czech Republic (n = 1), 44 Egypt (n = 1), 51 France (n = 6), 25 , 37 , 41 , 71 , 77 , 114 Germany (n = 7), 12 , 48 – 50 , 92 , 105 , 111 Greece (n = 1), 82 Hungary (n = 1), 61 India (n = 10), 19 , 29 , 39 , 40 , 67 , 75 , 76 , 86 , 98 , 115 Iran (n = 1), 87 Italy (n = 5), 22 , 24 , 43 , 46 , 91 Ivory Coast (n = 1), 13 Japan (n = 2), 57 , 106 Mexico (n = 1), 45 Nepal (n = 1), 28 Pakistan (n = 2), 62 , 97 Poland (n = 1), ...…”

“…As for the meta-analysis, 77 papers were excluded, 12 , 14 – 16 , 20 – 23 , 26 – 31 , 33 – 39 , 41 , 43 – 47 , 49 – 51 , 53 – 55 , 57 – 60 , 63 , 64 , 66 , 68 – 73 , 75 , 78 , 79 , 81 – 83 , 85 , 86 , 88 – 90 , 92 , 93 , 95 , 96 , 99 – 101 , 103 , 105 , 106 , 113 , 114 , 118 , 120 – 124 , 126 , 128 because 76 studies were lacking of relevant data 12 , 14 – 16 , 20 – 23 , 26 – 31 , 33 – 39 , 41 , 43 – 47 , 49 – 51 , 53 – 55 , 57 – 59 , 63 , 64 , 66 ,…”

Construction and Validation of an Instrument for Assessment of the Nursing Diagnosis, Risk for Infection, in Patients Following Cardiac Surgery

“…Impaired renal function, peripheral arterial disease, and immunosuppressant state were also found as independent RFs for the development of sternal dehiscence after cardiac surgery (Schimmer et al., ). Among 34 patients with hepatic cirrhosis who underwent cardiac surgery in France, 34% experienced infection, which can be explained by the presence of dysfunctions in the mechanisms of defense against infection: decreased reticuloendothelial system and granulocyte function, decreased complement concentrations and changes in cell‐mediated immunity, modifications to the digestive flora and the intestinal barrier, and malnutrition and hypoalbuminemia (Vanhuyse et al., ).…”

Periportal fibrosis without cirrhosis does not affect outcomes after continuous flow ventricular assist device implantation

“…End organ dysfunction, specifically hepatic dysfunction, can be a major complication of heart failure, and leads to increased mortality. [7][8][9][10] Advanced heart failure therapies, such as cardiac transplantation and VAD implantation, are relatively contraindicated in patients with severe liver disease. Cardiac surgery has been empirically accepted to be contraindicated in patients with hepatic cirrhosis, but more data are needed to support this assumption.…”

“…For example, severe hepatic cirrhosis (Child-Turcotte-Pugh, class C) has been shown to unacceptably increase mortality after cardiac surgery; whereas patients with class A cirrhosis have acceptable outcomes. 7 Recently, the model for end-stage liver disease (MELD) scores has been shown to predict VAD perioperative transfusion requirements and operative mortality. 12,13 However, the causes of hepatic dysfunction in patients with heart failure are likely multifactorial, and MELD scores fail to distinguish reversible from irreversible hepatopathy and were designed for use in patients with proven cirrhosis.…”