Original article: cardiovascularClinical outcome after cardiac operations in patients with cirrhosis
Section snippets
Patients and methods
We reviewed the records of all patients who underwent cardiovascular surgery at Kurume University from February 1989 to January 2003. Eighteen patients were found to have a preoperative history of cirrhosis confirmed by the medical records. The diagnosis of cirrhosis was made either by liver biopsy or signs of portal hypertension with characteristic morphologic changes of the liver and spleen confirmed by ultrasound, computed tomography, and magnetic resonance imaging. Other diagnostic
Patient characteristics
Preoperative patient characteristics and liver function tests for 18 patients were summarized in Table 1, Table 2. The causes of cirrhosis were viral hepatitis in 12 patients, alcohol related in 3, congestive heart failure in 1, primary biliary cirrhosis in 1, and unknown in 1. Four patients had mild to moderate ascites, and 8 had esophageal or gastric varices preoperatively. Ten patients were classified as having Child-Pugh class A cirrhosis, 7 as having Child-Pugh class B cirrhosis, and 1 as
Comment
Several epidemiologic studies have demonstrated that cirrhosis and hepatocellular carcinoma caused by hepatitis B and C virus infection were highly prevalent in the Asian countries, especially in Japan 7, 8. Although the prevalence declined gradually, at least 4% of elderly Japanese have contracted viral hepatitis [9]. Moreover, because of a steep increase in alcohol consumption, mortality as a result of alcohol-related liver disease is increasing [10]. Therefore, liver disease is still a major
Acknowledgements
This work was supported in part by the Grant-in-Aid for Encouragement of Young Scientists, Japan Society for the Promotion of Science (grant A-13770754 and grant A-14770696) and Grant-in-Aid for scientific research (grant C-13671416 and grant C-14571290), Japan.
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