Ahn Yeo Hyun, Kim Ji Yeun, Lee Sang Il, Kim Kyung Tae, Choe Won Joo, Park Jang Su, Kim Jung Won
Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
Korean J Anesthesiol. 2009 May;56(5):578-582. doi: 10.4097/kjae.2009.56.5.578.
Open heart surgery under cardiopulmonary bypass (CPB) in patients with liver cirrhosis is prone to the development of various complications associated with high mortality rates. According to recent studies, patients with advanced cirrhosis (Child-Pugh class B or C cirrhosis) have a significantly higher mortality rate (50-100%) after open heart surgery under CPB. We report the anesthetic management of cardiac surgery using CPB of 61-year-old man with aortic valve regurgitation, tricuspid regurgitation and ventricular septal defect (VSD) who had complicated by liver cirrhosis of Child-Pugh class B. The patient underwent successfully aortic valve replacement, tricuspid valvuloplasty and VSD closure. The use of tranexamic acid and transfusion of fresh whole blood appears to produce beneficial effects for outcome.
肝硬化患者在体外循环（CPB）下进行心脏直视手术容易出现各种并发症，死亡率很高。根据最近的研究，晚期肝硬化（Child-Pugh B级或C级肝硬化）患者在CPB下进行心脏直视手术后的死亡率显著更高（50%-100%）。我们报告了一名61岁患有主动脉瓣反流、三尖瓣反流和室间隔缺损（VSD）且合并Child-Pugh B级肝硬化的男性患者在CPB下进行心脏手术的麻醉管理。该患者成功接受了主动脉瓣置换、三尖瓣成形术和VSD修补术。使用氨甲环酸和输注新鲜全血似乎对预后产生了有益影响。
