TITLE:
Cirrhotic Patients Undergoing Cardiac Surgery: Why Not to Develop a More Specific Heart-Liver Score?
AUTHORS:
Alessandro Morgante
KEYWORDS:
Liver Cirrhosis, Cardiac Surgery, Risk Score
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.11 No.1,
January
20,
2021
ABSTRACT: Despite not included in the traditional risk scores before surgery, liver cirrhosis, especially in advanced stages, has always influenced strongly final outcome both on short and midterm in patients undergoing cardiac surgery. Growing incidence of non-alcoholic fatty liver disease interlinked with metabolic syndrome and significant advancements in medical therapy have actually increased the likelihood of cardiac surgery in cirrhotic patients. To date, Child-Pugh and MELD scores have been commonly used to predict mortality and postoperative hepatic decompensation, but on the other hand, both traditional risk scores show some limitations for evaluation of hepatopathic patients undergoing specifically cardiac surgery. In this context, a specific Heart-Liver score hasn’t been developed yet in the attempt to outline a patient profile able to face surgery, therefore addressing us to adopt the best strategy possible for each case. If CP class A or low MELD score (