Stanford type A aortic dissection with Child B liver cirrhosis

Area of Science:

• Cardiovascular Surgery
• Hepatology
• Anesthesiology

Background:

• Cardiac surgery in patients with advanced liver cirrhosis is associated with high risk and is infrequently performed.
• Aortic dissection co-occurring with liver cirrhosis is exceptionally rare, posing significant surgical challenges.

Observation:

• A 61-year-old female patient with Child B liver cirrhosis presented with aortic dissection.
• The patient underwent surgical repair involving ascending aorta replacement.

Findings:

• Successful liver protection strategies were implemented during cardiopulmonary bypass.
• Moderate hypothermia and the use of an aortic occlusion balloon were key to maintaining adequate hepatic blood flow.

Implications:

• This case demonstrates the feasibility of performing complex cardiac surgery, such as aortic dissection repair, in patients with advanced liver cirrhosis.
• The employed liver protection methods offer a potential strategy for improving perioperative outcomes in this high-risk patient population.