Assessing Right Ventricular Function in the Perioperative Setting, Part II

Vandenheuvel, Michaël; Bouchez, Stefaan; Wouters, Patrick; Mauermann, Eckhard

doi:10.1016/j.anclin.2019.08.004

Cited by 2 publications

(1 citation statement)

References 117 publications

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“…71 A thorough perioperative transesophageal echo (TEE) assessment is important to review the RV function, the severity of TR, PA thromboembolic occlusions, and inter-atrial septal defects. [72][73][74] Hypoxemia is common among CTEPH patients and excluding patent foramen ovalis or other septal defects is important. 75,76 However, hidden left-side structural problems such as mitral regurgitation may be masked by an under-filled left heart.…”

Section: Anesthesia and Monitoring During Pulmonary Endarterectomymentioning

confidence: 99%

Perioperative Management in Pulmonary Endarterectomy

Jenkins

Martínez

Salaunkey

et al. 2023

Semin Respir Crit Care Med

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Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH), provided lesions are proximal enough in the pulmonary vasculature to be surgically accessible and the patient is well enough to benefit from the operation in the longer term. It is a major cardiothoracic operation, requiring specialized techniques and instruments developed over several decades to access and dissect out the intra-arterial fibrotic material. While in-hospital operative mortality is low (<5%), particularly in high-volume centers, careful perioperative management in the operating theater and intensive care is mandatory to balance ventricular performance, fluid balance, ventilation, and coagulation to avoid or treat complications. Reperfusion pulmonary edema, airway hemorrhage, and right ventricular failure are the most problematic complications, often requiring the use of extracorporeal membrane oxygenation to bridge to recovery. Successful PEA has been shown to improve both morbidity and mortality in large registries, with survival >70% at 10 years. For patients not suitable for PEA or with residual PH after PEA, balloon pulmonary angioplasty and/or PH medical therapy may prove beneficial. Here, we describe the indications for PEA, specific surgical and perioperative strategies, postoperative monitoring and management, and approaches for managing residual PH in the long term.

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Section: Anesthesia and Monitoring During Pulmonary Endarterectomymentioning

confidence: 99%

Perioperative Management in Pulmonary Endarterectomy

Jenkins

Martínez

Salaunkey

et al. 2023

Semin Respir Crit Care Med

View full text Add to dashboard Cite

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Cardiothoracic Anesthesia and Critical Care: An Ever-Changing (and Evolving) Field

Bartels¹,

Dieleman

2019

Anesthesiology Clinics

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Cardiothoracic Anesthesia and Critical Care respectively. In a separate article, the ethical dilemmas of the increasing technical possibilities in the field of mechanical circulatory support are considered. 5 The articles on optimization of clinical care encompass a review of both echocardiographic 6 and catheter-based intraoperative assessment of right ventricular function, 7 optimization of coagulation and blood transfusion management, 8 prevention of perioperative acute kidney injury, 9 as well as an overview of the aspects of perioperative management of adult patients with congenital heart disease. 10 Two articles focused on emerging basic science will outline the effects of cardiac surgery on mitochondrial 11 and blood-brain barrier function, 12 respectively. Finally, an update is provided on recent, upcoming, and highly needed clinical trials, 13 in order to make cardiac anesthesiology an even more evidence-based field.While we cannot claim that this issue of Anesthesiology Clinics provides an all-encompassing picture of developments in the field of cardiothoracic anesthesiology and critical care, we believe that the authors offer a thought-provoking summary of exciting insights driven by leaders in our field. We would like to sincerely thank the authors of this issue for providing their valuable time to share this progress with our readers, and we hope readers will enjoy their contributions as much as we did.

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Assessing Right Ventricular Function in the Perioperative Setting, Part II

Cited by 2 publications

References 117 publications

Perioperative Management in Pulmonary Endarterectomy

Perioperative Management in Pulmonary Endarterectomy

Cardiothoracic Anesthesia and Critical Care: An Ever-Changing (and Evolving) Field

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