Cardiovascular surgery in the patients with liver dysfunction

Under the current situations we have increasing opportunities to manage the patients with posthepatitis and/or congestive liver dysfunction. In order to prevent postoperative hepatic failure we described perioperative management for those patients. For this purpose, the major point is the selection of appropriate operative methods which reduce operative invasions and have sure efficacy. In order to decide operative methods, we have to grasp the functional reserve of dysfunctional liver. We have no effective methods to estimate the functional reserve, but our data suggested that serum cholinesterase level at the preoperative states might demonstrate prognostic significance. The others are managements of postoperative cardiopulmonary distress and infection. It goes without saying that preoperative improvement of anemia and poor nutrition.