Document Detail


Effects of cardiac valve dysfunction on perioperative management of liver transplantation.
MedLine Citation:
PMID:  19545715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our aim was to investigate the effects of cardiac valve dysfunction on perioperative management of orthotopic liver transplantation (OLT) among a retrospective cohort. PATIENTS AND METHODS: Three hundred forty-six patients underwent echocardiographic (ECHO) examination prior to OLT. Data of patients with valvular dysfunctions were compared to subjects with normal ECHO. We evaluated patient characteristics, operation variables, hemodynamic course, blood products, fluid and drug requirements, extubation, and mortality rates. RESULTS: Ninety-five patients (27.5%) with cardiac valve dysfunction were classified as mitral valve insufficiency (MVI; n = 32), tricuspid valve insufficiency (TVI; n = 23), or both MVI and TVI (n = 40). One hundred fifty-two patients displayed normal ECHO examinations (control). Ninety-nine patients with other pathologies were excluded from the study. Systemic vascular resistance was significantly lower among the MVI group, and cardiac output (CO) significantly higher in the MVI and both MVI and TVI groups compared with controls. More MVI and both MVI and TVI patients required epinephrine compared with controls. The number of patients who required blood transfusion was higher in the MVI than the control group (P < .05). Patient characteristics, end-stage liver failure scores, duration of operations, hemodynamic variables, incidence of postreperfusion syndrome, mean doses of ephedrine and epinephrine, red blood cells, fresh frozen plasma and fluid requirements, number of patients extubated immediately after surgery, and mortality rates were not different between the groups. CONCLUSIONS: Our study demonstrated that cardiac valve dysfunction may be associated with end-stage liver disease among patients undergoing OLT. Patients with MVI or both MVI and TVI required more care in perioperative management.
Authors:
I Alper; S Ulukaya; F Demir; M Kilic
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-23     Completed Date:  2009-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1722-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey. i.alper@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheterization, Central Venous
Echocardiography
Female
Heart Valve Diseases / epidemiology*,  physiopathology,  ultrasonography
Hemodynamics / physiology
Humans
Liver Cirrhosis / classification,  surgery
Liver Transplantation / adverse effects,  mortality,  physiology*
Living Donors
Male
Middle Aged
Pulmonary Artery
Reference Values
Retrospective Studies
Survival Rate
Survivors
Tissue Donors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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