Perioperative Cardiovascular Evaluation for Orthotopic Liver Transplantation.
Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant. Careful screening and rigorous management of cardiovascular risk factors are important to ensure optimal cardiovascular outcomes in the immediate post-transplantation period and in the long term as well.
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA.
Robert J
RJ
Donovan
Department of Medicine, Randall VAMC, University of Florida, Gainesville, FL, USA.
Calvin
C
Choi
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA. Asghar.Ali@va.gov.
Asghar
A
Ali
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA.
Douglas M
DM
Heuman
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA.
Michael
M
Fuchs
Department of Medicine, Randall VAMC, University of Florida, Gainesville, FL, USA.
Anthony A
AA
Bavry
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA.
Ion S
IS
Jovin
D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D016031:Liver Transplantation; D008403:Mass Screening; D055414:Myocardial Perfusion Imaging; D019990:Perioperative Care / Q000379:methods*; D018570:Risk Assessment; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
Cardiovascular risk; Coronary artery disease; End-stage liver disease; Liver transplantation