title: Successful off-pump pericardiectomy and coronary artery bypass in liver cirrhosis.
abstract: Cardiopulmonary bypass can be detrimental to patients with hepatic cirrhosis. Pericardiectomy performed on the beating heart is an effective treatment for pericardial constriction. Off-pump coronary artery bypass grafting is becoming firmly established as a surgical option for myocardial ischemia associated with multivessel disease. A single-stage operation combining both procedures without utilizing cardiopulmonary bypass has not been reported. This provided excellent surgical outcome for a patient with the dual pathology and coexisting liver cirrhosis. The off-pump approach should be considered in such a high-risk scenario.
authors.affiliation: Division of Cardiovascular Surgery, Toronto General Hospital, University Health Network, University of Toronto, Ontario, Canada. gus@tang-family.org
authors.forename: Augustine T M
authors.initials: AT
authors.lastname: Tang
authors.forename: Jacek
authors.initials: J
authors.lastname: Karski
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cusimano
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D010492:Pericardiectomy / Q000379:methods*; D010494:Pericarditis, Constrictive / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome