Anesthetic experience of aortic valve replacement, tricuspid valvuloplasty and VSD closure in a patient with Child-Pugh class B liver cirrhosis : A case report.

Ahn,  Yeo Hyun; Kim,  Ji Yeun; Lee,  Sang Il; Kim,  Kyung Tae; Choe,  Won Joo; Park,  Jang Su; Kim,  Jung Won

doi:2009.56.5.578

Case Report

Korean Journal of Anesthesiology 2009;56(5):578-582.
DOI: https://doi.org/10.4097/kjae.2009.56.5.578

Anesthetic experience of aortic valve replacement, tricuspid valvuloplasty and VSD closure in a patient with Child-Pugh class B liver cirrhosis : A case report.

Yeo Hyun Ahn, Ji Yeun Kim, Sang Il Lee, Kyung Tae Kim, Won Joo Choe, Jang Su Park, Jung Won Kim

Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea. jy67925@naver.com

Abstract

Open heart surgery under cardiopulmonary bypass (CPB) in patients with liver cirrhosis is prone to the development of various complications associated with high mortality rates. According to recent studies, patients with advanced cirrhosis (Child-Pugh class B or C cirrhosis) have a significantly higher mortality rate (50-100%) after open heart surgery under CPB. We report the anesthetic management of cardiac surgery using CPB of 61-year-old man with aortic valve regurgitation, tricuspid regurgitation and ventricular septal defect (VSD) who had complicated by liver cirrhosis of Child-Pugh class B. The patient underwent successfully aortic valve replacement, tricuspid valvuloplasty and VSD closure. The use of tranexamic acid and transfusion of fresh whole blood appears to produce beneficial effects for outcome.

Key Words: Cardiopulmonary bypass; Fresh whole blood; Liver cirrhosis; Open heart surgery; Tranexamic acid