Casestudies

CABG IN LIVER FAILURE

||CABG IN LIVER FAILURE||

55 years old gentleman know case of autoimmune hepatitis, old CVA, CKD. He presented with ongoing chest pain with recurrent episodes of rest angina with coronary angiogram revealed severe triple vessel disease. Due to chronic liver failure, patient had ascites and pulmonary hypertension. He was posted for high risk CABG under Dr. Srinath Vijayasekharan, Dr. Senthil kumar and Team.  Intraoperatively he had difficult intubation and also high airway pressure with supra systemic pulmonary artery pressure. TEE revealed moderate to severe mitral regurgitation but it was dynamic suggesting ischemic origin of MR hence it was decided to proceed for CABG under cardiopulmonary bypass without replacing the mitral valve. Post operatively he remained hemodynamically stable and discharged without any major complications.

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