Cirrhose et circulation extracorporelle

Abstract

Early and late outcome after elective cardiac surgery in patients with cirrhosis is not well known. We have conducted a study which tried to evaluate the outcome in patients who underwent elective cardiac surgery with cardiopulmonary bypass and suspected on admission to the cardiothoracic service to have a history of hepatic cirrhosis. The results suggested that, in patients with mild or moderate cirrhosis, the incidence of significant complications was high after elective cardiac surgery, increasing the length of stay in ICU and overall hospitalization time. Infection rate was increased and further hepatic dysfunction was noted, as well as cardiac tamponade in these patients with portal hypertension and thrombocytopenia. In a practical point of view, this study allowed the creation of a program of evaluation of the patients suspected to have a history of cirrhosis. The esophageal varices were eradicated when present and the patients with Child B cirrhosis were all contra-indicated. However, further studies are required before giving definitive recommendations for the prevention and treatment of complications occurring after elective cardiac surgery with cardiopulmonary bypass.