Successful surgical treatment of cardiac cirrhosis. Tricuspid surgery and plasma exchange.

A patient with cardiac cirrhosis due to severe tricuspid regurgitation associated with a mitral valve lesion successfully underwent mitral and tricuspid valve replacement. Preoperative rest cure with liver supporting therapy for 5 months was used to maximize hepatic and cardiac function. Postoperatively, jaundice developed despite improvements in cardiac function. Plasma exchange was performed nine times over a period of 10 days with the liver function improved. He was discharged with New York Heart Association class I symptoms and normal liver function 2 months following surgery.