Operative outcome of cardiac surgery in patients with liver cirrhosis

Kentaro Yamane, Kenta Izumi, Shiro Yamachika, Koji Hashizume, Kazuyoshi Tanigawa, Takashi Miura, Wataru Hashimoto, Tomohiro Odate, Shun Nakaji, Kiyoyuki Eishi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: A retrospective study was performed to investigate the relationship between the severity of liver cirrhosis and the outcome of cardiac surgery. Methods and Results: Twenty-one patients with liver cirrhosis underwent cardiac surgery in our institution. According to the Child-Pugh classification, 13 patients were in class A, 7 in class B, and 1 in class C. Coronary artery bypass grafting was performed in 7 patients, surgery for valvular disease in 10 and other procedures in 4. Major postoperative complications occurred in 8%, 29%, and 100% for Child-Pugh class A, B, and C, respectively. Preoperative hemoglobin level was significantly lower in the patients with postoperative complications. None of 4 patients underwent coronary revascularization using off-pump procedure or mini-pump system experienced major complication. The operative mortality was 0%, 14%, and 0%for Child-Pugh class A, B, and C, respectively. Conclusions: Although the overall mortality rate in patients with liver cirrhosis was acceptable in our study, the incidence of severe complications, such as prolonged ventilation, mediastinitis and irreversible hepatic insufficiency was problematic in Child-Pugh class B and class C patients. Application of less invasive cardiac surgery, such as mini-pump system or off-pump procedure will improve the operative outcome in such patient group.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalActa Medica Nagasakiensia
Volume53
Issue number1
StatePublished - 2008

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Liver Cirrhosis
Thoracic Surgery
Hepatic Insufficiency
Mediastinitis
Mortality
Coronary Artery Bypass
Ventilation
Hemoglobins
Cohort Studies
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Yamane, K., Izumi, K., Yamachika, S., Hashizume, K., Tanigawa, K., Miura, T., ... Eishi, K. (2008). Operative outcome of cardiac surgery in patients with liver cirrhosis. Acta Medica Nagasakiensia, 53(1), 15-21.
Yamane, Kentaro ; Izumi, Kenta ; Yamachika, Shiro ; Hashizume, Koji ; Tanigawa, Kazuyoshi ; Miura, Takashi ; Hashimoto, Wataru ; Odate, Tomohiro ; Nakaji, Shun ; Eishi, Kiyoyuki. / Operative outcome of cardiac surgery in patients with liver cirrhosis. In: Acta Medica Nagasakiensia. 2008 ; Vol. 53, No. 1. pp. 15-21.
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abstract = "Introduction: A retrospective study was performed to investigate the relationship between the severity of liver cirrhosis and the outcome of cardiac surgery. Methods and Results: Twenty-one patients with liver cirrhosis underwent cardiac surgery in our institution. According to the Child-Pugh classification, 13 patients were in class A, 7 in class B, and 1 in class C. Coronary artery bypass grafting was performed in 7 patients, surgery for valvular disease in 10 and other procedures in 4. Major postoperative complications occurred in 8{\%}, 29{\%}, and 100{\%} for Child-Pugh class A, B, and C, respectively. Preoperative hemoglobin level was significantly lower in the patients with postoperative complications. None of 4 patients underwent coronary revascularization using off-pump procedure or mini-pump system experienced major complication. The operative mortality was 0{\%}, 14{\%}, and 0{\%}for Child-Pugh class A, B, and C, respectively. Conclusions: Although the overall mortality rate in patients with liver cirrhosis was acceptable in our study, the incidence of severe complications, such as prolonged ventilation, mediastinitis and irreversible hepatic insufficiency was problematic in Child-Pugh class B and class C patients. Application of less invasive cardiac surgery, such as mini-pump system or off-pump procedure will improve the operative outcome in such patient group.",
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Yamane, K, Izumi, K, Yamachika, S, Hashizume, K, Tanigawa, K, Miura, T, Hashimoto, W, Odate, T, Nakaji, S & Eishi, K 2008, 'Operative outcome of cardiac surgery in patients with liver cirrhosis', Acta Medica Nagasakiensia, vol. 53, no. 1, pp. 15-21.

Operative outcome of cardiac surgery in patients with liver cirrhosis. / Yamane, Kentaro; Izumi, Kenta; Yamachika, Shiro; Hashizume, Koji; Tanigawa, Kazuyoshi; Miura, Takashi; Hashimoto, Wataru; Odate, Tomohiro; Nakaji, Shun; Eishi, Kiyoyuki.

In: Acta Medica Nagasakiensia, Vol. 53, No. 1, 2008, p. 15-21.

Research output: Contribution to journalArticle

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T1 - Operative outcome of cardiac surgery in patients with liver cirrhosis

AU - Yamane, Kentaro

AU - Izumi, Kenta

AU - Yamachika, Shiro

AU - Hashizume, Koji

AU - Tanigawa, Kazuyoshi

AU - Miura, Takashi

AU - Hashimoto, Wataru

AU - Odate, Tomohiro

AU - Nakaji, Shun

AU - Eishi, Kiyoyuki

PY - 2008

Y1 - 2008

N2 - Introduction: A retrospective study was performed to investigate the relationship between the severity of liver cirrhosis and the outcome of cardiac surgery. Methods and Results: Twenty-one patients with liver cirrhosis underwent cardiac surgery in our institution. According to the Child-Pugh classification, 13 patients were in class A, 7 in class B, and 1 in class C. Coronary artery bypass grafting was performed in 7 patients, surgery for valvular disease in 10 and other procedures in 4. Major postoperative complications occurred in 8%, 29%, and 100% for Child-Pugh class A, B, and C, respectively. Preoperative hemoglobin level was significantly lower in the patients with postoperative complications. None of 4 patients underwent coronary revascularization using off-pump procedure or mini-pump system experienced major complication. The operative mortality was 0%, 14%, and 0%for Child-Pugh class A, B, and C, respectively. Conclusions: Although the overall mortality rate in patients with liver cirrhosis was acceptable in our study, the incidence of severe complications, such as prolonged ventilation, mediastinitis and irreversible hepatic insufficiency was problematic in Child-Pugh class B and class C patients. Application of less invasive cardiac surgery, such as mini-pump system or off-pump procedure will improve the operative outcome in such patient group.

AB - Introduction: A retrospective study was performed to investigate the relationship between the severity of liver cirrhosis and the outcome of cardiac surgery. Methods and Results: Twenty-one patients with liver cirrhosis underwent cardiac surgery in our institution. According to the Child-Pugh classification, 13 patients were in class A, 7 in class B, and 1 in class C. Coronary artery bypass grafting was performed in 7 patients, surgery for valvular disease in 10 and other procedures in 4. Major postoperative complications occurred in 8%, 29%, and 100% for Child-Pugh class A, B, and C, respectively. Preoperative hemoglobin level was significantly lower in the patients with postoperative complications. None of 4 patients underwent coronary revascularization using off-pump procedure or mini-pump system experienced major complication. The operative mortality was 0%, 14%, and 0%for Child-Pugh class A, B, and C, respectively. Conclusions: Although the overall mortality rate in patients with liver cirrhosis was acceptable in our study, the incidence of severe complications, such as prolonged ventilation, mediastinitis and irreversible hepatic insufficiency was problematic in Child-Pugh class B and class C patients. Application of less invasive cardiac surgery, such as mini-pump system or off-pump procedure will improve the operative outcome in such patient group.

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Yamane K, Izumi K, Yamachika S, Hashizume K, Tanigawa K, Miura T et al. Operative outcome of cardiac surgery in patients with liver cirrhosis. Acta Medica Nagasakiensia. 2008;53(1):15-21.