OPCAB surgery in a cirrhotic hepatocellular carcinoma patient awaiting liver transplant.
Cirrhosis was once thought of as an absolute contraindication to cardiac surgery with the risk of liver decompensation following the use of cardiopulmonary bypass. With the advent of off-pump coronary artery bypass grafting, the possibility of reducing the risk of decompensation may make this type of surgery suitable for patients who will eventually undergo orthotopic liver transplantation. We present the strategy used in a patient with multifocal hepatocellular carcinoma and cirrhosis who underwent coronary artery bypass grafts for unstable angina, in order to allow him to undergo liver transplantation at a future date.
Department of Cardiothoracic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom. noahalkh@talk21.com
Cornelia
C
Carr
Jatin
J
Desai
D000789:Angina, Unstable / Q000150:complications / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery; D047549:Coronary Artery Bypass, Off-Pump; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012501:Saphenous Vein / Q000637:transplantation; D013895:Thoracic Arteries / Q000637:transplantation