title: Preoperative Cardiac Assessment of Patients Undergoing Orthotopic Liver Transplantation: Experience in One Center.
abstract: Preoperative cardiac evaluation of patients undergoing liver transplantation is not well established. Stress testing is used in many centers, and clinical guidelines suggest its use. However, the specificity and sensibility of stress echocardiography to predict coronary lesions have been very low in some studies. Moreover, it has a low positive predictive value to predict complications after liver transplantation. We retrospectively analyzed 143 patients who underwent liver transplantation in our center and report our experience in the use of stress echocardiography. We describe cardiac complications during and after liver transplantation. Low prevalence of ischemic heart disease in asymptomatic patients undergoing liver transplantation make stress testing useless in risk stratification because it has a low positive predictive value. So the risk stratification of these patients before liver transplant surgery remains a challenge.
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain. Electronic address: antoniograndetrillo@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Grande-Trillo
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Sobrino-Márquez
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Escobedo-Mesas
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Rangel-Sousa
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: J E
authors.initials: JE
authors.lastname: López-Haldón
authors.affiliation: Heart Unit, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Lage-Gallé
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D025401:Echocardiography, Stress / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity