Objectives:
Coronary artery bypass grafting in cirrhotic patients carries high risk of morbidity and mortality. Most of these complications are related to hepato-renal failure, bleeding and postoperative wound infection rather than cardiac problems.
Methods:
Prospective study to evaluate elective CABG early postoperative outcome of elective CABG in patients with Class A Child Pugh liver cirrhosis.
Results
From October 2007 to April 2011total 59 patients with Class A liver failure underwent elective CABG.37male, 22female.42hypertensives and 28diabetics.Mean1st 24hours chest tube drainage was 853.80±56.10ml, minimal 130ml maximum 3500 ml.12 patients (20.3%) were re-explored for bleeding. Mean ventilation time was 10.48± 6.65 hours. Mean ICU stay was 59.52± 13.91hours. Two patients (3.38%) died one patient due to hepato-renal failure (re explored 3 times) while the 2nd patient died after delayed recovery due to cerebral hemorrhage . 20 patients (33.89%) had wound infection ,two need debridement and rewiring . Mean hospital stay was 9.18±2.29days. Total morbidity was 49%. Total mortality was 3.38%.
Conclusion:
Elective CABG can be tolerated satisfactorily in class A Child Pugh cirrhotic patients with high incidence of the postoperative complications specially bleeding and wound infection.