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Effects of cardiac valve dysfunction on perioperative management of liver transplantation

I Alper1, S Ulukaya, F Demir

  • 1Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey. i.alper@yahoo.com

Transplantation Proceedings
|June 24, 2009
PubMed

Insights

Cardiac valve dysfunction, particularly mitral valve insufficiency (MVI) or combined MVI and tricuspid valve insufficiency (TVI), is linked to end-stage liver disease in liver transplant patients. These patients require intensified perioperative management.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Surgery

Background:

  • Cardiac valve dysfunction is a common comorbidity in patients with end-stage liver disease.
  • The impact of cardiac valve dysfunction on perioperative management during orthotopic liver transplantation (OLT) requires further investigation.

Purpose of the Study:

  • To investigate the effects of cardiac valve dysfunction on perioperative management in patients undergoing OLT.
  • To compare outcomes between patients with and without cardiac valve dysfunction during OLT.

Main Methods:

  • A retrospective cohort study of 346 patients undergoing OLT.
  • Echocardiographic (ECHO) examination prior to OLT to identify valvular dysfunctions.
  • Comparison of patient characteristics, operative variables, hemodynamic course, and resource utilization between groups.

Main Results:

  • 27.5% of patients had cardiac valve dysfunction (mitral valve insufficiency [MVI], tricuspid valve insufficiency [TVI], or both).
  • MVI and combined MVI/TVI groups showed lower systemic vascular resistance and higher cardiac output.
  • MVI and combined MVI/TVI groups required more epinephrine and blood transfusions compared to controls.

Conclusions:

  • Cardiac valve dysfunction is associated with end-stage liver disease in OLT candidates.
  • Patients with MVI or combined MVI/TVI necessitate more intensive perioperative care during OLT.
Abstract

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