Preoperative Assessment of Congestive Liver Dysfunction Using Technetium-99 m Galactosyl Human Serum Albumin Liver Scintigraphy in Patients with Severe Valvular Heart Disease

Nishi, Hiroyuki; Takahashi, Tetsuya; Matsumiya, Goro; Takano, Hiroshi; Ichikawa, Hajime; Miyagawa, Shigeru; Sawa, Yoshiki

doi:10.1007/s00595-006-3460-x

Cited by 10 publications

(6 citation statements)

References 18 publications

(31 reference statements)

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“…For this reason, hepatic congestion is a factor contributing to liver injury because of abnormal microcirculation in the liver (Masai et al 2002;Nishi et al 2007). Thus, the restoration of oxidative stress-induced vascular disorders in cerulein treated AP rats substantiates the protective action of drugs on liver.…”

Section: Discussionmentioning

confidence: 99%

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

et al. 2015

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Acute pancreatitis (AP) may cause significant persistent multi-organ dysfunction. Carvacrol (CAR) possesses a variety of biological and pharmacological properties. The aim of the present study was to analyze the hepatic protection of CAR on AP induced by cerulein and to explore the underlying mechanism using in vivo studies. The rats were randomized into groups to receive (1) no therapy; (2) 50 lg/kg cerulein at 1-h intervals by four intraperitoneal injection (i.p.); (3) 50, 100 and 200 mg/kg CAR by one i.p.; and (4) cerulein ? CAR after 2 h of cerulein injection. 12 h later, serum was provided to assess the blood AST, ALT and LDH values. Also, liver tissues were obtained for histological and biochemical measurements. Liver oxidative stress markers were evaluated by changes in the amount of lipid peroxides measured as MDA and changes in tissue antioxidant enzyme levels, SOD, CAT and GSHPx. Histopathological examination was performed using scoring systems. Oxidative damage to DNA was quantitated in studied tissues of experimental animals by measuring the increase in 8-hydroxydeoxyguanosine (8-OHdG) formations. We found that the increasing doses of CAR decreased pancreatitisinduced MDA and 8-OH-dG levels. Moreover, the liver SOD, CAT and GSH-Px activities in the AP ? CAR group were higher than that of the rats in the AP group. In the treatment groups, AST, ALT and LDH were reduced. Besides, necrosis, coagulation and inflammation in the liver were alleviated (p \ 0.05). We suggest that CAR could be a safe and potent new drug candidate for treating AP through its antioxidative mechanism of action for the treatment of a wide range of disorders related to hepatic dysfunction.

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Section: Discussionmentioning

confidence: 99%

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

et al. 2015

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“…An association between tricuspid valve dysfunction and liver disease due to hepatic congestion has been well established [21, 22]. Suman and coworkers [18] demonstrated a strong correlation between CTP, MELD, and mortality (AUC = 0.84 and 0.87, respectively) in 44 patients primarily undergoing coronary artery bypass graft surgery.…”

Section: Commentmentioning

confidence: 99%

Model for End-Stage Liver Disease Predicts Mortality for Tricuspid Valve Surgery

Ailawadi¹,

LaPar²,

Swenson³

et al. 2009

The Annals of Thoracic Surgery

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Background Patients undergoing tricuspid valve surgery have a mortality of 9.8%, which is higher than expected given the complexity of the procedure. Despite liver dysfunction seen in many patients with tricuspid disease, no existing risk model accounts for this. The Model for End-Stage Liver Disease (MELD) score accurately predicts mortality for abdominal surgery. The objective of this study was to determine if MELD could accurately predict mortality after tricuspid valve surgery and compare it to existing risk models. Methods From 1994 to 2008, 168 patients (mean age, 61 ± 14 years; male = 72, female = 96) underwent tricuspid repair (n = 156) or replacement (n = 12). Concomitant operations were performed in 87% (146 of 168). Patients with history of cirrhosis or MELD score 15 or greater (MELD = 3.8*LN [total bilirubin] + 11.2*log normal [international normalized ratio] + 9.6*log normal [creatinine] + 6.4) were compared with patients without liver disease or MELD score less than 15. Preoperative risk, intraoperative findings, and complications including operative mortality were evaluated. Statistical analyses were performed using χ2, Fisher’s exact test, and area under the curve (AUC) analyses. Results Patients with a history of liver disease or MELD score of 15 or greater had significantly higher mortality (18.9% [7 of 37] versus 6.1% [8 of 131], p = 0.024). To further characterize the effect of MELD, patients were stratified by MELD alone. No major differences in demographics or operation were identified between groups. Mortality increased as MELD score increased, especially when MELD score of 15 or greater (p = 0.0015). A MELD score less than 10, 10 to 14.9, 15 to 19.9, and more than 20 was associated with operative mortality of 1.9%, 6.8%, 27.3%, and 30.8%, respectively. By multivariate analysis, MELD score of 15 or greater remained strongly associated with mortality (p = 0.0021). The MELD score predicted mortality (AUC = 0.78) as well as the European System for Cardiac Operative Risk Evaluation logistic risk calculator (AUC = 0.78, p = 0.96). Conclusions The MELD score predicts mortality in patients undergoing tricuspid valve surgery and offers a simple and effective method of risk stratification in these patients.

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“…Although it was unclear whether her liver function was good enough for this operation, we thought that the relieved congestion after the cardiac operation would benefi t the liver and decided that it was the treatment of choice. 7 As there are still no clear indications for surgery in patients with congestive liver dysfunction, we performed the operation after we had treated her right heart failure medically and her liver congestion had improved. We surmised that triple valve replacement may reduce the right ventricular load and eventually improve her clinical status, regardless of the delayed surgery.…”

Section: Discussionmentioning

confidence: 99%

Triple valve replacement late after tetralogy of Fallot repair: Report of a case

et al. 2008

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Right ventricular failure after repair of tetralogy of Fallot (TOF) is associated with late mortality and morbidity. We report a case of tricuspid and mitral regurgitation with severe pulmonary regurgitation (PR) diagnosed 31 years after repair of TOF. The patient, a 48-year-old woman, presented with severe ventricular arrhythmia and exercise intolerance. She was treated successfully with triple valve replacement, following which her symptoms improved dramatically. She has remained well for 2 years postoperatively.

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Preoperative Assessment of Congestive Liver Dysfunction Using Technetium-99 m Galactosyl Human Serum Albumin Liver Scintigraphy in Patients with Severe Valvular Heart Disease

Abstract: The level of HH15 calculated using scintigraphy with (99m)Tc-GSA is a clinically useful predictor of postoperative liver dysfunction in patients with severe valvular disease.

Cited by 10 publications

References 18 publications

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

Model for End-Stage Liver Disease Predicts Mortality for Tricuspid Valve Surgery

Triple valve replacement late after tetralogy of Fallot repair: Report of a case

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