title: Impact of hepatic cirrhosis on outcome in adult cardiac surgery.
abstract: Increasing prevalence of hepatic disease is likely to translate in a growing number of patients with significant hepatic disease requiring cardiac surgery. Available cardiac risk stratification models do not address the risk associated with hepatic disease. However, weighted mean mortality rates based on previous studies of cardiac surgery in patients with hepatic disease demonstrate operative mortality rates that range from 9.88% (standard deviation [SD] 9.69) for patients in Child-Turcotte-Pugh (CTP) class A cirrhosis to 69.23% (SD 28.55) for patients with CTP class C cirrhosis. This review comprehensively appraises the pathophysiology of hepatic disease, reported clinical outcomes and considerations for risk stratification.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Dimarakis
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom.
authors.forename: Stuart
authors.initials: S
authors.lastname: Grant
authors.affiliation: Department of Clinical Oncology Research, University Hospital South Manchester, Manchester, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Corless
authors.affiliation: Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Theodore
authors.initials: T
authors.lastname: Velissaris
authors.affiliation: Department of Gastroenterology, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom.
authors.forename: Ben
authors.initials: B
authors.lastname: Bridgewater
authors.affiliation: Department of Cardiac Surgery, Bristol Heart Institute, University Hospitals Bristol, Bristol, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Asimakopoulos
mesh_terms: D001778:Blood Coagulation Disorders / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome