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Coronary events in patients undergoing orthotopic liver transplantation: perioperative evaluation and management
Author(s) -
Ali Asghar,
Bhardwaj Hem L.,
Heuman Douglas M.,
Jovin Ion S.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12113
Subject(s) - medicine , perioperative , cardiology , liver transplantation , myocardial infarction , percutaneous coronary intervention , transplantation , coronary artery disease , myocardial perfusion imaging , dobutamine , surgery , hemodynamics
Patients with advanced liver disease have a high prevalence of cardiac risk factors. The stress of liver transplant surgery predisposes these patients to major cardiac events, such as myocardial infarction or ventricular arrhythmias in addition to heart failure exacerbation. Liver transplant patients who experience coronary events in the perioperative period have a decreased five‐yr survival rate. Cardiovascular risk stratification prior to liver transplant can be accomplished by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computed tomography, and coronary angiography. Pre‐liver transplant management of cardiovascular pathology includes cardiovascular intervention like percutaneous coronary intervention, coronary bypass graft surgery, or medical management. Thorough screening and optimal management of underlying cardiovascular pathology and cardiovascular risk factors should decrease the incidence of new cardiac events in liver transplant recipients.