A Case of Simultaneous Liver Transplantation and Mitral Valve Replacement in a HCV Cirrhotic Patient with Severe Mitral Valve Stenosis

We report a case ofsimultaneous liver transplantation and mitral valve replacement in a 53 years old woman suffering for a severe HCV - related liver cirrhosis (CHILD C12, MELD 26), severe mitral stenosis and chronic atrial fibrillation. Cardiac surgery was performed on cardiopulmonary bypass with full heparinization and cardiac arrest and preceded liver transplantation. The patient was weaned on postoperative day 2 from mechanical ventilation and on postoperative day 5 from hemodynamic support and renal replacement therapy. She was transferred to the ward on POD 12. On POD 20 she was readmitted to ICU for acute kidney failure, worsening graft function, sepsis and the suspicion of acute rejection. On POD 56 after a long intensive treatment, the patient eventually died from an intracranial hemorrhage. This complex combined surgery carries a high burden of morbidity and mortality but showed a good result in the short term.