Author + information
- Received August 17, 2012
- Revision received November 2, 2012
- Accepted November 9, 2012
- Published online January 1, 2013.
- Anubhav Garg, MD and
- William F. Armstrong, MD⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. William F. Armstrong, University of Michigan Medical Center, Department of Internal Medicine, Division of Cardiology, Cardiovascular Center Floor 2 Room 2161, 1500 East Medical Center Drive SPC 5853, Ann Arbor, Michigan 48109-5853
Involvement of the cardiovascular system in patients with end-stage liver disease (ESLD) is well recognized and may be seen in several scenarios in adult liver transplantation (LT) candidates. The hemodynamic effects of ESLD may result in apparent heart disease, or in some instances may mask cardiac disease. Alternatively, cardiac disease can occasionally be the underlying etiology of ESLD. LT imposes significant hemodynamic stresses, with cardiovascular complications accounting for considerable perioperative mortality and morbidity. Pre-operative assessment of the cardiac status of LT candidates is thus critically important for risk stratification and management. Cardiac imaging plays an integral role in the assessment of LT candidates. In this review, we discuss the role of cardiac imaging, including transthoracic echocardiography with Doppler and contrast enhancement, noninvasive functional assessment for routine pre-operative assessment of coronary artery disease, and transesophageal echocardiography in select cases to aid in intra-operative fluid management and monitoring in LT candidates.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 17, 2012.
- Revision received November 2, 2012.
- Accepted November 9, 2012.
- American College of Cardiology Foundation