BACKGROUND: Severe valvular heart disease is often complicated by congestive liver dysfunction, which greatly compromises the operative results. We evaluated congestive liver dysfunction by a novel approach using technetium-99 m galactosyl human serum albumin ((99m)Tc-GSA) with liver scintigraphy. METHODS: Between 1998 and 2004, we performed scintigraphy accompanied by (99m)Tc-GSA in 28 patients who had valvular heart disease with moderate-to-severe tricuspid regurgitation and who showed symptoms of right heart failure. Based on the results, we calculated a receptor index (LHL15) and an index of blood clearance (HH15) and assessed the correlation between these factors and postoperative liver dysfunction, defined as the maximum serum total bilirubin level (max T-bil) as >2.0 mg/dl. RESULTS: Nineteen patients, including four who died in hospital, had postoperative liver dysfunction. The level of HH15 was significantly higher and the level of cholinesterase was significantly lower (P < 0.05) in patients with liver dysfunction than in those without liver dysfunction. Multivariate logistic regression analysis identified HH15 as the most sensitive indicator of postoperative hepatic dysfunction. CONCLUSIONS: 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.
BACKGROUND: Severe valvular heart disease is often complicated by congestive liver dysfunction, which greatly compromises the operative results. We evaluated congestive liver dysfunction by a novel approach using technetium-99 m galactosyl human serum albumin ((99m)Tc-GSA) with liver scintigraphy. METHODS: Between 1998 and 2004, we performed scintigraphy accompanied by (99m)Tc-GSA in 28 patients who had valvular heart disease with moderate-to-severe tricuspid regurgitation and who showed symptoms of right heart failure. Based on the results, we calculated a receptor index (LHL15) and an index of blood clearance (HH15) and assessed the correlation between these factors and postoperative liver dysfunction, defined as the maximum serum total bilirubin level (max T-bil) as >2.0 mg/dl. RESULTS: Nineteen patients, including four who died in hospital, had postoperative liver dysfunction. The level of HH15 was significantly higher and the level of cholinesterase was significantly lower (P < 0.05) in patients with liver dysfunction than in those without liver dysfunction. Multivariate logistic regression analysis identified HH15 as the most sensitive indicator of postoperative hepatic dysfunction. CONCLUSIONS: 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.
Authors: William A Zoghbi; Maurice Enriquez-Sarano; Elyse Foster; Paul A Grayburn; Carol D Kraft; Robert A Levine; Petros Nihoyannopoulos; Catherine M Otto; Miguel A Quinones; Harry Rakowski; William J Stewart; Alan Waggoner; Neil J Weissman Journal: J Am Soc Echocardiogr Date: 2003-07 Impact factor: 5.251
Authors: J Wu; N Ishikawa; T Takeda; Y Tanaka; X Q Pan; M Sato; T Todoroki; R Hatakeyama; Y Itai Journal: Ann Nucl Med Date: 1995-11 Impact factor: 2.668
Authors: S K Ha-Kawa; Y Tanaka; S Hasebe; Y Kuniyasu; K Koizumi; Y Ishii; K Yamamoto; T Kashiwagi; A Ito; M Kudo; K Ikekubo; T Tsuda; K Murase Journal: Eur J Nucl Med Date: 1997-02
Authors: Gorav Ailawadi; Damien J Lapar; Brian R Swenson; Suzanne A Siefert; Christine Lau; John A Kern; Benjamin B Peeler; Keith E Littlewood; Irving L Kron Journal: Ann Thorac Surg Date: 2009-05 Impact factor: 4.330