[HSF] Operating on Liver Cirrhotics

[prasannasimha]

Ani vasodilator perfusion is more based on theoretical construct of 
decreased hepatic flow with CPB. It is like TRT its use has to be 
ultimately be proved.It has been shown that nitrate infusions increases 
hepatic flow during CPB. Delivering targetted would be better hopefully.
Prasanna
Ani Anyanwu wrote:
> I would be keen to know approaches members use to reduce the morbidity or mortality associated with cardiac surgery in patients with liver cirrhosis.  
> We have an active liver transplant program and few times a year i have to operate on patients requiring liver transplant who have co-existing cardiac problems. These patients seem so unpredictable and mortality has been high such that on occasion some surgeons have done the (cardiac) procedure in combination with the liver transplant.
> I would be grateful for any tips on dealing with this difficult group. Prassana I know has a regime of hepatic infusion of venodilators - is their logic or data to back this and do others have experience of this technique? Do people give Factor VII pre-emptively?
> Thanks
> Ani
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the policies and 
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------
>
>
>