Thorac Cardiovasc Surg 2015; 63(01): 058-066
DOI: 10.1055/s-0034-1389084
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Impact of Hepatic Cirrhosis on Outcome in Adult Cardiac Surgery

Ioannis Dimarakis
1   Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom
,
Stuart Grant
1   Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom
,
Rebecca Corless
2   Department of Clinical Oncology Research, University Hospital South Manchester, Manchester, United Kingdom
,
Theodore Velissaris
3   Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Manchester, United Kingdom
,
Martin Prince
4   Department of Gastroenterology, Manchester Royal Infirmary, Manchester, United Kingdom
,
Ben Bridgewater
1   Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, United Kingdom
,
George Asimakopoulos
5   Department of Cardiac Surgery, Bristol Heart Institute, University Hospitals Bristol, Bristol, United Kingdom
› Author Affiliations
Further Information

Publication History

21 April 2014

04 July 2014

Publication Date:
07 October 2014 (online)

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Abstract

Increasing prevalence of hepatic disease is likely to translate in a growing number of patients with significant hepatic disease requiring cardiac surgery. Available cardiac risk stratification models do not address the risk associated with hepatic disease. However, weighted mean mortality rates based on previous studies of cardiac surgery in patients with hepatic disease demonstrate operative mortality rates that range from 9.88% (standard deviation [SD] 9.69) for patients in Child–Turcotte–Pugh (CTP) class A cirrhosis to 69.23% (SD 28.55) for patients with CTP class C cirrhosis. This review comprehensively appraises the pathophysiology of hepatic disease, reported clinical outcomes and considerations for risk stratification.