Predictive Risk Factors for Patients With Cirrhosis Undergoing Heart Surgery

Arif, Rawa; Seppelt, Philipp; Schwill, Simon; Kojic, D; Ghodsizad, Ali; Ruhparwar, Arjang; Kretzler, Matthias; Kallenbach, Klaus

doi:10.1016/j.athoracsur.2012.06.057

Cited by 77 publications

(62 citation statements)

References 12 publications

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“…Unfortunately, the presence of end-stage liver disease can be a contraindication for cardiac surgery, including heart transplant, with significant morbidity and mortality. Mortality rates have been reported as high as 50% for patients undergoing heart surgery who are in the highest model for end-stage liver disease (MELD) score category [1][2][3]. Advanced therapies for end-stage heart failure remain isolated to either mechanical circulatory support or the "gold standard" orthotopic heart transplant.…”

mentioning

confidence: 97%

Combined Heart and Liver Transplantation Can Be Safely Performed With Excellent Short- and Long-Term Results

Atluri

Gaffey

Howard

et al. 2014

The Annals of Thoracic Surgery

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mentioning

confidence: 97%

Combined Heart and Liver Transplantation Can Be Safely Performed With Excellent Short- and Long-Term Results

Atluri

Gaffey

Howard

et al. 2014

The Annals of Thoracic Surgery

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“…Arif, et al reported 30-day mortality was 26% in patients with liver cirrhosis. 24) Patients categorized as CHILD classification B and C had a significantly high 30-day mortality (33% and 40%, respectively) compared with CHILD A (20%). Modi, et al reported estimated mortality rates of 5% for patients categorized as CHILD A, 32% for CHILD B, and 67% for CHILD C. 25) Postoperative liver dysfunction, coagulation abnormalities, and difficulty in intravascular volume management would be the reasons for the worse outcome in patients with liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…Modi, et al reported estimated mortality rates of 5% for patients categorized as CHILD A, 32% for CHILD B, and 67% for CHILD C. 25) Postoperative liver dysfunction, coagulation abnormalities, and difficulty in intravascular volume management would be the reasons for the worse outcome in patients with liver cirrhosis. 24) Frailty has been recently recognized as a significant factor to be taken into account when selecting patients for TAVR. Frailty is considered to be a distinct clinical syndrome characterized by a decrease in muscle mass and energy expenditure as well as mal-nutrition, leading to extreme vulnerability to adverse events.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis —In the Era of Transcatheter Aortic Valve Replacement

Seki

Sakakibara

Shingu

et al. 2015

ATCS

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Purpose: Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic option for severe aortic valvular stenosis (AS). To determine the indication for TAVR, it is mandatory to clarify the characteristics of the patients who were judged as inoperable for conventional aortic valve replacement (cAVR). Methods: Of 185 patients newly diagnosed as severe AS from March 2010 to April 2011, we studied the characteristics of 61 (33%) patients (mean age, 86 ± 8 years) who were judged as inoperable. Results: Younger patients (<85 years old, n = 22) had more major comorbidities and lower left ventricular ejection fraction than older patients (≥85 years old, n = 39). Mean estimated mortality for cAVR by Japan score was 7.0% ± 7.4%. Japan score did not correlate to age and was calculated relatively low in the older age group (6.2% ± 7.0%) than the younger age group (8.3% ± 8.1%). Conclusion: One thirds of severe AS patients were judged as inoperable. In advanced age patients, age itself and other factors, which are not included in the conventional scoring systems, might have contributed to the decision making not to perform cAVR by cardiologists. Further study is necessary to define risk factors except for age.

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“…Filsoufi et al [28] reported, in a retrospective study, an overall mortality of 26% after cardiac surgery in patients with cirrhosis, and an adjusted mortality of [35]. In a recent retrospective paper led on a small cohort of 55 patients undergoing cardiac surgery with mild or severe cirrhosis, neither MELD nor Child predicts early and late mortalities [36].…”

Section: Patient With Pre-operative Liver Diseasementioning

confidence: 99%