Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis

Background: Liver cirrhosis is known to be associated with increased morbidity and mortality in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the early outcomes of cardiac surgery in patients with liver cirrhosis in our settings, and to assess the performance of the Child-Pugh classification as a predictor of early mortality. Patients and Methods: A retrospective observational study included 58 patients operated between March 2012 and October 2019. Among these 52 patients required open-heart procedures and 6 were operated without the use of cardiopulmonary bypass. The primary endpoint being examined was early mortality. Results: The overall mortality was 20.7%. Higher Child-Pugh (CP) class was associated with marked rise in mortality. The mortality rate increased from 10.8% patients in class A of the Child-Pugh, to 25% in class B patients to 80% in class C patients. The need for urgent or emergent procedures was also found to be associated with an increased risk of mortality. Conclusion: Early results of cardiac surgery in Child-Pugh class A patients although apparently higher than the general population, remain acceptable. The mortality in patients with CP class C is extremely high and almost prohibitive. Non-elective procedures also seemed to be associated with a significant increase in early mortality. This should be borne in mind while assessing surgical risk in cirrhotic patients.