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- W2008366273 abstract "During the last two decades, results in cardiac surgery have improved significantly owing to a better management of high-risk patients. Cirrhotic patients submitted to cardiopulmonary bypass (CPB) have traditionally been associated to an increased operative risk. To better characterize the risk of patients with cirrhosis undergoing cardiopulmonary bypass in the current era of Cardiac Surgery, we reviewed our institutional experience since 2000. Twenty six patients with cirrhosis undergoing CPB were identified and categorized according to the Child-Pugh classification: Child A (N = 11), Child B (N = 15). Patients in both groups were comparable in terms of age, etiology of cirrhosis, type of surgery and Parsonnet score. Postoperatively, Child B patients had a significantly increased rate of lung infection (A = 9,1% vs B = 66,7%; P = 0.005) which tended to be linked to an intubation time > 48h (A = 9,1% vs B = 46,7%; P = 0.08). Renal complications were significantly higher in the Child B group (A = 18,2% vs B = 80,0%; P = 0.004). Length of hospital stay tended to be longer in the Child B group: A = 10.1 ± 5.9 days vs B = 18.3 ± 16.7 days; P = 0.13. Hospital mortality was greater in the Child B group (A = 18,2% vs B = 60,0%; P = 0.05). At a mean follow-up of (1.0 ± 1.6 years), the 3 year survival was 77.8% and 21.3% respectively for groups A and B (P = 0.03). When analyzing the whole cohort of patients to identify preoperative variables linked to hospital mortality, solely Child B class (OR 8.1; CI1.04-99; P = 0.04) and Parsonnet score (OR 1.1; CI:1.03-1.53; P = 0.02) increased significantly hospital mortality. Cirrhosis remains a significant risk factor for patients undergoing cardiopulmonary bypass. The Child-Pugh classification is relevant to assess preoperatively. Patients with Child B cirrhosis, especially if associated to a high Parsonnet, are linked to a high hospital mortality and morbidity as well as a dismal mid-term survival and should command extreme caution in the selection of candidates for cardiac surgery." @default.
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- W2008366273 date "2011-09-01" @default.
- W2008366273 modified "2023-09-25" @default.
- W2008366273 title "105 Impact of cirrhosis in patients undergoing cardiopulmonary bypass: Results of a contemporary cohort of patients" @default.
- W2008366273 doi "https://doi.org/10.1016/j.cjca.2011.07.269" @default.
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