Preoperative cardiac evaluation of patients undergoing liver transplantation is not well established. Stress testing is used in many centers, and clinical guidelines suggest its use. However, the specificity and sensibility of stress echocardiography to predict coronary lesions have been very low in some studies. Moreover, it has a low positive predictive value to predict complications after liver transplantation. We retrospectively analyzed 143 patients who underwent liver transplantation in our center and report our experience in the use of stress echocardiography. We describe cardiac complications during and after liver transplantation. Low prevalence of ischemic heart disease in asymptomatic patients undergoing liver transplantation make stress testing useless in risk stratification because it has a low positive predictive value. So the risk stratification of these patients before liver transplant surgery remains a challenge.
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