1. Institute Institute of Cardiovascular Diseases Prof Dr George IM Georgescu, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania WC. Hsieh, PC. Chen, G. Gradinariu, G.Tinica Prevalence and risk factors of postoperative morbidity after cardiac surgery in patients with chronic viral hepatitis: A RETROSPECTIVE STUDY

2. introduction Introduction 2 Current commonly used risk scores (STS-Score, EuroSCORE II ) that evaluate operative mortality and morbidity in cardiac surgery do not account for liver dysfunction Our aim is to evaluate the prevalence and risk factors for postoperative morbidity after cardiac surgery in patients with chronic viral hepatitis

3. A total of 105 patients in 12 years evaluated with the MELD score In subjects who were on anticoagulants, MELD-XI was used We checked for postoperative outcomes, including cardiac complications, neurological complications, infection, acute renal failure, and arrhythmia. Method 3

4. Result-statistical analysis 4 FactorsWald Chi-SquareAdjusted OR (95% CI)P value Valuvar (vs. CAD)4.49573.48 (1.10-11.00)0.0340 Valuvar+CAD (vs. CAD)5.031712.27 (1.37-109.77)0.0249 Aortic valve replacement (AVR) (vs. CABG) 3.93400.26 (0.07- 0.98)0.0473 Bilirubin, (mg/dl) 4.17493.63 (1.05-12.49)0.0410

5. Approximately 4 million people in the USA live with chronic hepatitis virus infection: hepatitis B and C virus Our results showed that the main postoperative complications for patients with chronic viral hepatitis after cardiac surgery were cardiac complications (54.3%) This is consistent with another study, which showed that cardiac complications(31), renal complications(21, 26), and hepatic complications(19) were the postoperative complications for patients with liver disease. Most studies showed that liver dysfunction (as reflected by preoperative bilirubin levels) could affect the postoperative morbidity in patients with cirrhosis (8, 11, 19, 22, 26, 27, 31, 33), and this was confirmed by our univariate analysis. We found that disease types (valvular, valvular+CAD), aortic valve replacement and bilirubin were the independent risk factors for morbidity. Discussion 5

6. Based on our study and univariate analysis, we found that the postoperative complication rate was very high in patients with hepatitis virus infection who underwent cardiac surgery Liver dysfunction could be added to available models to predict the hospital morbidity for patients with chronic viral hepatitis who undergo elective cardiac surgery Conclusion 6