Single-Stage Combined Ascending Aortic and Aortic Valve Replacement With Orthotopic Liver Transplantation: A Rare Multidisciplinary Approach.

Kothari, Purab D; Shah, Vishal N; Mounzer, Marc; Aikhionbare, Itohan; Nasher, Nayeem; Maley, Warren; Plestis, Konstadinos A · Ann Thorac Surg · 2026

case_report · Level V

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Abstract

Combined cardiac surgery and orthotopic liver transplantation is exceedingly rare because of prohibitive cross-organ risks and substantial technical complexity. Particularly in patients with severe aortic valve insufficiency from a large ascending aortic aneurysm and concomitant end-stage liver disease, isolated cardiac surgery or liver transplantation alone may be futile.<sup>1-4</sup> This case illustrates that the exceptionally rare combination of complex aortic surgery and orthotopic liver transplantation can be successfully performed in carefully selected patients.

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