Cirrhosis Can Impact Heart Surgery Success

Two-thirds of those with severe disease died after cardiac surgery, study found

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THURSDAY, July 12, 2007 (HealthDay News) -- For patients with cirrhosis, the severity of the disease will predict how well they do after heart surgery, a new study finds.

While milder cases of the liver ailment will have less of an impact on heart surgery outcomes, patients with severe cirrhosis may require alternative approaches to managing their heart disease, according to research published in the July issue of Liver Transplantation.

Cirrhosis is a degenerative disease of the liver that causes a scarring of the tissues, prevents blood flow through the organ and ultimately impairs liver function. It is often brought on by heavy alcohol use, or infection with hepatitis B or C.

While the relationship between the degree of cirrhosis and the success of abdominal surgeries is well known, few studies have examined outcomes for heart surgery, the researchers noted.

In their study, a team led by Dr. Farzan Filsoufi of Mount Sinai Hospital in New York City examined data from patients who had heart surgeries at the center between January 1998 and December 2004. They identified 27 patients with cirrhosis.

Cirrhosis prognosis and possibility for success in surgery for cirrhosis patients is characterized according to the "Child-Pugh classification" as A, B or C, with A being the most optimistic outcome and C being the least.

According to the study, there was a 10 percent postsurgical mortality rate for those in class A, an 18 percent mortality for those in class B, and a 67 percent death rate for those in class C.

The rates of complications after the surgery were 55 percent for patients in class B and 100 percent in class C, the researchers added.

Based on the findings, the authors concluded heart surgery can be performed safely and with a good likelihood for survival for cirrhosis patients in class A. They therefore recommended careful selection of heart surgery patients with cirrhosis to help improve the chance of successful outcomes.

Patients with advanced cirrhosis may require alternative approaches to heart surgery, such as medically managing their heart disease until it is possible to perform surgery at the same time as a liver transplant, the researchers wrote.

More information

To learn about liver diseases, visit the American Liver Foundation.

SOURCE: Liver Transplantation, news release, July 3, 2007

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