Perioperative Management of the Right and Left Ventricles.

Brent C Lampert

Journal: Cardiology clinics 2018;36(4):495-506

PMID: 30297067

Full Text on Elsevier Science View on PubMed

Abstract

Left ventricular assist devices (LVADs) improve survival in select advanced heart failure patients and rates of LVAD implantation are growing. LVAD support carries significant morbidity and mortality with the greatest risk in the perioperative period. Strategies have evolved to minimize this risk. Medical and mechanical support is used for right and left ventricular optimization. Other strategies emphasize improving nutrition, hematologic abnormalities, infection risk, and renal function. Intraoperative approaches highlight anesthesia-related issues, management of concomitant valve disease, right ventricular failure, and weaning from cardiopulmonary bypass. Postoperative efforts concentrate on augmenting right ventricular function, supporting end-organ recovery, and quickly identifying complications.

Address: Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 473 West 12th Avenue, Suite 200, Columbus, OH 43210, USA. Electronic address: [email protected].

DOI: 10.1016/j.ccl.2018.06.004

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MeSH Terms: Cardiac Surgical Procedures, Heart Failure, Heart Ventricles, Heart-Assist Devices, Humans, Perioperative Care, Ventricular Function, Left, Ventricular Function, Right