Combined off pump coronary artery bypass graft and liver transplant
| العنوان: | Combined off pump coronary artery bypass graft and liver transplant |
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| المؤلفون: | Harpreet Wasir, Ajay Kumar, Yatin Mehta, Vijay Vohra, Rajeev Ranjan, Rajiv Juneja, P M Hemantlal, Naresh Trehan |
| المصدر: | Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia, Vol 24, Iss 2, Pp 197-202 (2021) |
| بيانات النشر: | Medknow, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Coronary Artery Bypass, Off-Pump, Revascularization, law.invention, Coronary artery disease, Coronary artery bypass surgery, Anesthesiology, coronary artery bypass graft, law, Atrial Fibrillation, Living Donors, Cardiopulmonary bypass, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, RD78.3-87.3, Coronary Artery Bypass, CABG, Retrospective Studies, Off-pump coronary artery bypass, off pump coronary artery bypass graft, Cardiopulmonary Bypass, combined surgery, business.industry, General Medicine, Perioperative, medicine.disease, Liver Transplantation, Surgery, Cardiac surgery, liver transplant, Treatment Outcome, Anesthesiology and Pain Medicine, RC666-701, Original Article, Cardiology and Cardiovascular Medicine, business, Living donor liver transplant |
| الوصف: | Background: Prospective recipients of liver transplant (LT) have a high prevalence rate of coronary artery disease (CAD) requiring revascularization. In patients of Child Turcot Pugh Class B and C performing LT prior to cardiac revascularization on cardiopulmonary bypass leads to a high risk of major adverse cardiovascular events (MACE). Whereas, isolated cardiac surgery prior to LT has perioperative risk of coagulopathy, sepsis, and hepatic decompensation. We present four cases of end stage liver disease who underwent concomitant living donor liver transplant (LDLT) with off pump coronary artery bypass graft (OPCAB) in an effort to decrease the morbidity and mortality. Methods: The cases were performed in a tertiary care centre over two years. Four patients scheduled for LDLT, who were diagnosed with significant CAD, underwent single sitting OPCAB and LDLT. Cardiac surgery was performed first and once patient was stable, it was followed by LDLT. The morbidity parameters in terms of duration of intubation, blood transfusion, hospital stay, ICU stay, requirement of dialysis, atrial fibrillation and sepsis was compared with similar studies. Results: The blood transfusion requirement (median 8 units PRBC), incidence of atrial fibrillation (25%), sepsis (25%), and renal dysfunction (0%) was less than the combined surgery conducted on cardiopulmonary bypass. The rate of median intubation time, length of ICU stay, hospital stay, and one year mortality rate was comparable with other studies. Conclusions: Morbidity with combined OPCAB and LDLT is less than combined on pump coronary artery bypass surgery with LDLT. Combined CABG with LDLT may be performed with acceptable outcomes in CTP class B and C cirrhosis. |
| تدمد: | 0971-9784 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bd4b493e0f8b804db6044e9bab4a7161Test https://doi.org/10.4103/aca.aca_194_19Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....bd4b493e0f8b804db6044e9bab4a7161 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09719784 |
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