Azzam, M., Derbala, H., Saleh, H. (2021). Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis. The Egyptian Journal of Hospital Medicine, 84(1), 2004-2007. doi: 10.21608/ejhm.2021.178628
Mohamed Azzam; Hussein Derbala; Hesham Zayed Saleh. "Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis". The Egyptian Journal of Hospital Medicine, 84, 1, 2021, 2004-2007. doi: 10.21608/ejhm.2021.178628
Azzam, M., Derbala, H., Saleh, H. (2021). 'Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis', The Egyptian Journal of Hospital Medicine, 84(1), pp. 2004-2007. doi: 10.21608/ejhm.2021.178628
Azzam, M., Derbala, H., Saleh, H. Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis. The Egyptian Journal of Hospital Medicine, 2021; 84(1): 2004-2007. doi: 10.21608/ejhm.2021.178628
Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis
Cardiothoracic Surgery Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Egypt.
Abstract
Background: Liver cirrhosis is known to be associated with increased morbidity and mortality in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the early outcomes of cardiac surgery in patients with liver cirrhosis in our settings, and to assess the performance of the Child-Pugh classification as a predictor of early mortality. Patients and Methods: A retrospective observational study included 58 patients operated between March 2012 and October 2019. Among these 52 patients required open-heart procedures and 6 were operated without the use of cardiopulmonary bypass. The primary endpoint being examined was early mortality. Results: The overall mortality was 20.7%. Higher Child-Pugh (CP) class was associated with marked rise in mortality. The mortality rate increased from 10.8% patients in class A of the Child-Pugh, to 25% in class B patients to 80% in class C patients. The need for urgent or emergent procedures was also found to be associated with an increased risk of mortality. Conclusion: Early results of cardiac surgery in Child-Pugh class A patients although apparently higher than the general population, remain acceptable. The mortality in patients with CP class C is extremely high and almost prohibitive. Non-elective procedures also seemed to be associated with a significant increase in early mortality. This should be borne in mind while assessing surgical risk in cirrhotic patients.