{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:37:07Z","timestamp":1782502627902,"version":"3.54.5"},"reference-count":86,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>The demand for cardiac surgery procedures is increasing globally. Thanks to an improvement in survival driven by medical advances, patients with liver disease undergo cardiac surgery more often. Liver disease is associated with the development of heart failure, especially in patients with advanced cirrhosis. Cardiovascular risk factors can also contribute to the development of both cardiomyopathy and liver disease and heart failure itself can worsen liver function. Despite the risk that liver disease and cirrhosis represent for the perioperative management of patients who undergo cardiac surgery, liver function is often not included in common risk scores for preoperative evaluation. These patients have worse short and long-term survival when compared with other cardiac surgery populations. Preoperative evaluation of liver function, postoperative management and close postoperative follow-up are crucial for avoiding complications and improving results. In the present narrative review, we discuss the pathophysiological components related with postoperative complications and mortality in patients with liver disease who undergo cardiac surgery and provide recommendations for the perioperative management.<\/jats:p>","DOI":"10.3389\/fsurg.2022.1053019","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T14:07:29Z","timestamp":1670335649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["The importance of liver function assessment before cardiac surgery: A narrative review"],"prefix":"10.3389","volume":"9","author":[{"given":"Juan C.","family":"Lopez-Delgado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Putzu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Landoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart disease and stroke statistics-2018 update: a report from the American heart association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s13019-017-0636-y","article-title":"The effect of preoperative liver dysfunction on cardiac surgery outcomes","volume":"12","author":"Araujo","year":"2017","journal-title":"J Cardiothorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1111\/j.1478-3231.2009.02058.x","article-title":"Morbidity and mortality following coronary artery bypass graft surgery in patients with cirrhosis: a population-based study","volume":"29","author":"Shaheen","year":"2009","journal-title":"Liver Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1111\/j.1365-2036.2011.04724.x","article-title":"Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults","volume":"34","author":"Vernon","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"key":"B5","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jhep.2018.05.036","article-title":"Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030","volume":"69","author":"Estes","year":"2018","journal-title":"J Hepatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"3410","DOI":"10.3748\/wjg.v20.i13.3410","article-title":"Chronic hepatitis C virus infection and atherosclerosis: clinical impact and mechanisms","volume":"20","author":"Adinolfi","year":"2014","journal-title":"World J Gastroenterol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1016\/j.ijcard.2015.10.181","article-title":"Preoperative hepatic dysfunction could predict postoperative mortality and morbidity in patients undergoing cardiac surgery: utilization of the MELD scoring system","volume":"203","author":"Murata","year":"2016","journal-title":"Int J Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.ejcts.2010.02.042","article-title":"Risk prediction and outcomes in patients with liver cirrhosis undergoing open-heart surgery","volume":"38","author":"Thielmann","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1510\/icvts.2010.241190","article-title":"Do patients with liver cirrhosis undergoing cardiac surgery have acceptable outcomes?","volume":"11","author":"Modi","year":"2010","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1093\/icvts\/ivs501","article-title":"Short-term independent mortality risk factors in patients with cirrhosis undergoing cardiac surgery","volume":"16","author":"Lopez-Delgado","year":"2013","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1093\/icvts\/ivu438","article-title":"Mortality after cardiac surgery in patients with liver cirrhosis classified by the Child-Pugh score","volume":"20","author":"Jacob","year":"2015","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1510\/icvts.2010.236141","article-title":"Surgical and transcatheter aortic valve procedures. 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