Early and late outcomes of cardiac operations in patients with cirrhosis

Gundling, Felix; Seidl, H.; Gansera, Laura; Schuster, Tibor; Hoffmann, Ellen; Kemkes, B. M.; Eichinger, Bernd; Gansera, Brigitte; Schepp, Wolfgang; Schmidtler, F.

doi:10.1097/meg.0b013e32834059b6

Cited by 13 publications

(2 citation statements)

References 26 publications

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“…Gundling et al . conducted an 8-year retrospective study and concluded that the necessity of blood product administration was increased in patients with liver cirrhosis undergoing cardiac surgery; the 30-day mortality rate was higher and long-term survival rate lower when compared to patients without liver cirrhosis 34 .…”

Section: Blood Transfusion In Complicated Cardiac Patientsmentioning

confidence: 99%

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Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective

et al. 2017

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In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement. It becomes difficult to demonstrate the association between transfusions and mortality because of the fact that most patients undergoing cardiac surgery are also critically ill. Transfusion rates remain high despite the advances in perioperative blood conservation, such as the intraoperative use of cell saver in cardiac surgery. Some recent prospective studies have suggested that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. In light of this information, we reviewed the literature to assess the clinical outcomes in terms of 30-day and 1-year morbidity and mortality in transfused patients who underwent uncomplicated CABG surgery.

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Section: Blood Transfusion In Complicated Cardiac Patientsmentioning

confidence: 99%

“…Furthermore, recent reports have indicated worse outcomes when transfusion is due to preoperative anemia or blood dyscrasias 33 , 34 . In 2014, Engoren et al .…”

Section: Blood Transfusion In Complicated Cardiac Patientsmentioning

confidence: 99%

Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective

et al. 2017

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Approach to the patient with decompensated cirrhosis and aortic stenosis during liver transplantation evaluation

et al. 2022

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Aortic stenosis (AS) is the most common valvular disease and is reported to be present in 2%–7% of people over the age of 65. Risk factors for aortic stenosis and NASH overlap; thus, as the population ages, there is an increased likelihood that patients undergoing liver transplantation evaluation may have severe aortic stenosis. There is a high mortality rate associated with cardiac surgeries in patients with cirrhosis. Further, there are no guidelines that assist in the decision making process for patients with cirrhosis and AS. In this review, we highlight key studies that compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in patients with cirrhosis. We propose an algorithm as to how to approach the patient with aortic stenosis and considerations unique to patients with cirrhosis (i.e., anticoagulation, EGD for variceal assessment; need to determine timing after TAVI before listing).

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Critical Care Management of the Adult Patient with Congenital Heart Disease: Focus on Postoperative Management and Outcomes

Roy

2015

Curr Treat Options Cardio Med

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Advances in surgical techniques and in the medical management of children with congenital heart disease has increased survival into adulthood, resulting in a population of adults with congenital heart disease now surpassing the pediatric population in numbers. Furthermore, many of the patients will require repeat surgical, catheter-based, procedures and/or obstetrical care in their adult lives, and understanding the specific cardiopulmonary physiology and the involvement of other organ systems is critical to successful intervention. A team approach, with consultants from medical specialties in the setting of an established adult congenital heart center, is the optimal setting for superior outcomes. In this review, we discuss critical care management of the adult congenital heart disease patient in the perioperative period.

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Early and late outcomes of cardiac operations in patients with cirrhosis

Abstract: Cardiac surgery can be performed safely in patients with Child-Pugh class A and selected patients with Child-Pugh class B cirrhosis. Mid-term survival-rates within 8 years were not significantly different compared with a propensity-score pair-matched control group without cirrhosis.

Cited by 13 publications

References 26 publications

Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective

Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective

Approach to the patient with decompensated cirrhosis and aortic stenosis during liver transplantation evaluation

Critical Care Management of the Adult Patient with Congenital Heart Disease: Focus on Postoperative Management and Outcomes

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