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Preoperative evaluation using asialoscintigraphy in patients undergoing cardiac surgery with noncardiac liver cirrhosis

Authors
  • Takami, Yoshiyuki1
  • Masumoto, Hiroshi1
  • 1 Kasugai Municipal Hospital, Division of Cardiovascular Surgery, 1-1-1 Takagi-cho, Kasugai, Aichi, 486-8510, Japan , Kasugai (Japan)
Type
Published Article
Journal
The Japanese Journal of Thoracic and Cardiovascular Surgery
Publisher
Springer-Verlag
Publication Date
Nov 01, 2006
Volume
54
Issue
11
Pages
463–468
Identifiers
DOI: 10.1007/s11748-006-0036-z
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectiveLiver cirrhosis is recognized as one of the risk factors for severe complications after cardiac surgery. However, there are no established methods for risk stratification of the patients with liver cirrhosis (LC) regarding cardiac surgery. We present our experience of preoperative evaluation of liver function using asialoscintigraphy.MethodsBetween April 1999 and December 2005, we evaluated preoperative liver function using asialoscintigraphy with technetium-99m galactosyl human serum albumin in four cirrhotic patients undergoing coronary artery bypass grafting (n = 2) and valve replacement (n = 2), whose etiologies of LC were alcoholabuse (n = 1) and hepatitis C virus infection (n = 3). They also underwent other tests for preoperative evaluation of liver function, including the indocyanine green (ICG) test.ResultsAsialoscintigraphy revealed that the receptor index and the index of blood clearance in each patient were 0.81/0.73, 0.95/0.5, 0.82/0.62, and 0.97/0.57, respectively. These values closely correlated with the results of the ICG test. All patients were discharged alive from hospital after surgery. However, although one patient who underwent off-pump bypass had an uneventful course, three patients had major complications: pleural effusion (n = 1) and wound infection (n = 2).ConclusionAsialoscintigraphy is a practical, reliable method that can replace the ICG test for estimating hepatic function for risk stratification of cirrhotic patients undergoing cardiac surgery, whose mortality and morbidity are still high.

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