Aortic stenosis with end-stage liver disease: prioritizing surgical and anesthetic therapies.
A 48-year-old man with end-stage liver disease and aortic stenosis (AS), was being evaluated for liver transplantation. This report focuses on the question of which medical problem to correct first, the end-stage liver disease or the AS. Risk factors for surgical correction of AS and liver transplantation are reviewed and discussed, and the surgical and anesthetic management strategies for this patient are outlined.
Pollard
R J
RJ
Department of Anesthesiology, University of Florida College of Medicine, Gainesville 32610-0254, USA.
Sidi
A
A
Gibby
G L
GL
Lobato
E B
EB
Gabrielli
A
A
D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000502:physiology; D006501:Hepatic Encephalopathy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage; D010347:Patient Care Planning; D012307:Risk Factors; D013390:Succinylcholine / Q000008:administration & dosage; D013874:Thiopental / Q000008:administration & dosage; D016277:Ventricular Function, Left / Q000502:physiology
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D007530:Isoflurane; D013390:Succinylcholine; D013874:Thiopental; D005283:Fentanyl