Transfemoral Transcatheter Aortic Valve Replacement for Mixed Aortic Valve Disease in Child's Class C Liver Disease Prior to Orthotopic Liver Transplantation: A Case Report.
The American Association for the Study of Liver Diseases practice guidelines list severe cardiac disease as a contraindication to liver transplantation. Transcatheter aortic valve replacement has been shown to decrease all-cause mortality in patients with severe aortic stenosis who are not considered candidates for surgical aortic valve replacement. We report our experience of liver transplantation in a patient with severe aortic stenosis and moderate aortic insufficiency who underwent transcatheter aortic valve replacement with Child-Pugh Class C disease at a Model For End-Stage Liver Disease score of 29. The patient had a difficult post procedure course that was successfully medically managed. After liver transplantation the patient was discharged to home on postoperative day 11. The combination of cardiac disease and end stage liver disease is challenging but these patients can have a successful outcome despite very severe illness.
['Wilkey|Barbara J|BJ|', 'Hanson|Ross|R|', 'Reece|T Brett|TB|', 'Forman|Lisa|L|', 'Burton|James R|JR|', 'Messenger|John C|JC|', 'Kim|Michael S|MS|', 'Cleveland|Joseph C|JC|', 'Fiegel|Matt J|MJ|', 'Nydam|Trevor L|TL|', 'Mandell|M Susan|MS|']
D000368:Aged D001022:Aortic Valve Insufficiency D001024:Aortic Valve Stenosis D005263:Femoral Artery D006801:Humans D016031:Liver Transplantation D065626:Non-alcoholic Fatty Liver Disease D013916:Thrombelastography D065467:Transcatheter Aortic Valve Replacement
aortic valve replacement cardiac anesthesia cardiac surgery coagulopathy heparin platelet function