title: Successful aortic valve replacement using dilutional ultrafiltration during cardiopulmonary bypass in a patient with Child-Pugh class C cirrhosis.
abstract: Open-heart surgery is a relatively high-risk procedure when performed in patients with Child-Pugh class C cirrhosis. Even though they can tolerate cardiac surgery with cardiopulmonary bypass (CPB), most of them suffer major postoperative complications and prolonged hospital stay. The present report describes a case of a patient with Child-Pugh class C cirrhosis who developed severe heart failure secondary to aortic valve stenosis. The patient underwent successful aortic valve replacement with the use of dilutional ultrafiltration during CPB to reduce adverse effects of CPB. He recovered smoothly after the operation without major postoperative complications. Thus, the use of dilutional ultrafiltration (DUF) during CPB appears to produce beneficial effects for improving outcomes in patients with decompensated cirrhosis who require open-heart surgery.
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan. k-iino@m8.dion.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Tomita
authors.forename: Shohjiro
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002908:Chronic Disease; D006333:Heart Failure / Q000209:etiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014462:Ultrafiltration / Q000379:methods