Related Experiment Video
Updated: Aug 23, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Open-heart surgery in pediatric patients with end-stage liver disease
Emile A Bacha1, Joel Hardin, David C Cronin
1Cardiothoracic Surgery, Pediatric and Congenital Cardiac Surgery, Chicago, IL, USA.
Insights
Pediatric cardiac surgery in children with end-stage liver disease (ESLD) is feasible but carries increased risks. Careful patient selection and management are crucial for improving outcomes in this vulnerable population.
Area of Science:
- Pediatric Cardiology
- Hepatology
- Critical Care Medicine
Background:
- End-stage liver disease (ESLD) presents significant challenges for pediatric patients requiring cardiac surgery.
- Limited data exists on the safety and outcomes of these complex procedures in children with ESLD.
Purpose of the Study:
- To evaluate the safety and outcomes of pediatric cardiac surgery in children with end-stage liver disease.
- To identify potential risk factors and best practices for managing these patients.
Main Methods:
- Retrospective review of 4 pediatric patients with biliary atresia or Alagille's syndrome undergoing cardiac surgery.
- Procedures included ventricular septal defect repair, tricuspid regurgitation repair, atrioventricular canal repair, subaortic stenosis repair, and supravalvular aortic stenosis repair.
Main Results:
- One patient (25%) died postoperatively.
- Three patients (75%) survived to discharge.
- At follow-up, one additional patient died awaiting liver transplantation.
- One patient received a successful liver transplant and is doing well.
Conclusions:
- Pediatric cardiac surgery in children with end-stage liver disease can be performed with acceptable outcomes, despite a higher mortality rate.
- Careful consideration of surgical risks and potential benefits is essential.
- Liver transplantation may be a viable option for improving long-term survival.
Abstract:
Little is known about the safety of pediatric cardiac surgery in children with end-stage liver disease. We reviewed our experience with 4 patients with biliary atresia or Alagille's syndrome who underwent repair of ventricular septal defect and tricuspid regurgitation, atrioventricular canal, subaortic stenosis, or supravalvular aortic stenosis. One patient died on postoperative day 2. All other patients survived to discharge. At follow-up, 1 patient died at home awaiting liver transplantation and the remaining patients are doing well. One patient received a successful liver transplant. Pediatric cardiac surgery in children with end-stage liver disease can be done safely, albeit with a higher mortality.
