The Patient with Severe Co-morbidities: Cardiac Disease

  • Shahriar Shayan
  • Andre M. De Wolf


In order to properly discuss the anesthetic management of patients with cardiac co-morbidities undergoing liver transplantation (LTx), we will first briefly describe the cardiovascular changes that occur as a result of liver failure, including hemodynamic changes and cirrhotic cardiomyopathy. We will then concentrate on the following co-morbidities: coronary artery disease, valvular heart disease, arrhythmias, and hypertrophic obstructive cardiomyopathy. Preoperative diagnosis of cardiac co-morbidities is essential to ensure preoperative optimization and proper intraoperative management and helps to determine the potential need for combined cardiac surgery and LTx. Cardiac complications after liver transplantation is an important cause for postoperative mortality with previous cardiac disease as the main risk factor [1]. Early postoperative death (within 30 days of LTx) is as high as 2.9% and 40% of these mortalities are due to cardiac complications [2]. Poor left...


Coronary artery disease Cardiomyopathy Preoperative evaluation Heart failure Myocardial stress test Arrhythmias 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Depatment of AnesthesiologyNorthwestern Memorial HospitalChicagoUSA

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