Assisting the Failing Heart

Vegas, Annette

doi:10.1016/j.anclin.2008.03.001

Cited by 8 publications

(7 citation statements)

References 71 publications

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“…Second generation devices abandoned efforts to replace the function of the ventricle and instead unload volume from the failing ventricle in a continuous, nonpulsatile fashion. An inflow cannula is placed in either the left atrium or, more commonly, the apex of the left ventricle (LV) and blood is pumped via a rotating impeller in an axial or centrifugal fashion to the ascending aorta [ 11 , 12 ]. These devices are vastly smaller, totally implantable generally into the pericardial space, silent, dependable, and require less anticoagulation than most of the prior generation devices thanks to their valveless, continuous-flow systems [ 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Compensation occurs via neurohormonal activation—high circulating catechol amines, natriuretic peptides, endothelin, and activation of the renin-angiotensin-aldosterone system—which results in ventricular remodeling. Hence, the mainstay of treatment is neurohormonal blockade [ 12 ]. The long-term effects of this malperfused and overly compensated state frequently result in hepatic, renal, or pulmonary insufficiency [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Ventricular assist devices and non-cardiac surgery

et al. 2015

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The use of ventricular assist devices has expanded significantly since their approval by the Food and Drug Administration in the United States in 1994. In addition to this, the prevalence of heart failure continues to increase. We aim to provide an overview of perioperative considerations and management of these patients for non-cardiac surgery. We performed a Medline search for the words “ventricular assist device,” “Heartmate” and “HeartWare” to gain an overview of the literature surrounding these devices, and chose studies with relevance to the stated aims of this review. Patients with ventricular assist devices are presenting more frequently for surgery not related to their cardiac pathology. As the mechanically supported population grows, general anesthesiologists will be faced with managing these patients, possibly outside of the tertiary care setting. The unique challenges of this patient population can best be addressed by a thorough understanding of ventricular assist device physiology and a multidisciplinary approach to care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ventricular assist devices and non-cardiac surgery

et al. 2015

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“…In patients with pulmonary hypertension and decreased ejection fraction, nesiritide may lead to improved postoperative renal function, decreased hospital length of stay and decreased mortality. 78 One of the challenges during separation from CPB and in the post-CPB phase, particularly after prolonged bypass time, is vasoplegic syndrome. Vasoplegic syndrome is characterized by severe, vasopressor-resistant vasodilation due to activation of nitric oxide synthase, vascular smooth muscle ATP-sensitive potassium channels, and relative deficiency of vasopressin.…”

Section: Restoration Of Mechanical Ventilation and Oxygenationmentioning

confidence: 99%

Anesthetic Management for Cardiopulmonary Bypass

Bechtel

Huffmyer

2014

Semin Cardiothorac Vasc Anesth

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Cardiopulmonary bypass has revolutionized the practice of cardiac surgery and allows safe conduct of increasingly complex cardiac surgery. A brief review of the bypass circuit is undertaken in this review. A more thorough review of the anesthetic management is accomplished including choice of anesthetic medications and their effects. The inflammatory response to cardiopulmonary bypass is reviewed along with interventions that may help ameliorate the inflammation.

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“…The IABP decreases afterload, decreases myocardial oxygen consumption, increases coronary artery perfusion, and modestly enhances cardiac output. 1,2 The IABP cannot provide total circulatory support. Patients must have some level of left ventricular function for an IABP to be effective.…”

Section: 4mentioning

confidence: 99%

Use of the Impella 2.5 in High-Risk Percutaneous Coronary Intervention

McCulloch

2011

Critical Care Nurse

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The Impella 2.5 is a percutaneously placed partial circulatory assist device that is increasingly being used in high-risk coronary interventional procedures to provide hemodynamic support. The Impella 2.5 is able to unload the left ventricle rapidly and effectively and increase cardiac output more than an intra-aortic balloon catheter can. Potential complications include bleeding, limb ischemia, hemolysis, and infection. One community hospital’s approach to establishing a multidisciplinary program for use of the Impella 2.5 is described.

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Assisting the Failing Heart

Cited by 8 publications

References 71 publications

Ventricular assist devices and non-cardiac surgery

Ventricular assist devices and non-cardiac surgery

Anesthetic Management for Cardiopulmonary Bypass

Use of the Impella 2.5 in High-Risk Percutaneous Coronary Intervention

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