Case 3—1995 three patients requiring both coronary artery bypass surgery and orthotopic liver transplantation
| Autor: | Linda Shore-Lesserson, Michael A. E. Ramsay, Kenneth L. Brayman, Joseph J. Morris, T C Gunning, Bradley J. Gawy, Christopher L. Hellman, T. R. Valek, Farshad Lalehzarian, Thomas H. Swygert, Troyen A. Brennan |
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| Rok vydání: | 1995 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Coronary Artery Disease Liver transplantation Coronary artery disease Angina Coronary artery bypass surgery Internal medicine medicine Humans Coronary Artery Bypass Cardiac catheterization Cardiopulmonary Bypass Ejection fraction business.industry Middle Aged medicine.disease Liver Transplantation Surgery Anesthesiology and Pain Medicine Heart failure Cardiology Female Blood Coagulation Tests Cardiology and Cardiovascular Medicine business Liver Failure |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 9:322-332 |
| ISSN: | 1053-0770 |
| DOI: | 10.1016/s1053-0770(05)80330-1 |
| Popis: | A 46-year-old 63-kg woman with a history of type II diabetes melhtus and heavy tobacco use presented with symptoms of congestive heart failure and angina precipitated by severe anemia. Cardiac enzymes obtained were not elevated. Therapy with digoxin, diuretics, and nitrates was initiated. Endoscopic examination showed bleeding esophageal varices. Past medical history was significant for hepatic cirrhosis believed to be secondary to methotrexate therapy for psoriasis, with no history of alcohol abuse, jaundice, or encephalopathy Cardiac catheterization showed severe quadruple-vessel atherosclerotlc coronary artery disease (CAD) with moderate hypoklnesis of the left ventricle and severe hypokmesis of the inferior and posterobasal walls and an ejection fraction of 0 5 to 0.6. Preoperative laboratory data included hematocrlt (HCT) 37%, prothrombin time (PT) 14.9 seconds, glucose 215 mg/dL, creatmine 0.6 |
| Databáze: | OpenAIRE |
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