TY - CHAP M1 - Book, Section TI - Chapter 11. Ventricular Assist Devices and Heart Transplantation A1 - Wasnick, John D. A1 - Hillel, Zak A1 - Kramer, David A1 - Littwin, Sanford A1 - Nicoara, Alina PY - 2011 T2 - Cardiac Anesthesia and Transesophageal Echocardiography AB - Adult heart surgery patients are increasingly older with varying degrees of preoperative ventricular failure. Patients routinely present with both systolic and diastolic ventricular dysfunction, ventricular remodeling, fluid retention, and pulmonary congestion. Additionally, even those patients with well-preserved ventricular function preoperatively can deteriorate intraoperatively secondary to inadequate myocardial preservation, embolism, myocardial ischemia, protamine reactions, and other "catastrophic" events (eg, anaphylaxis, aortic dissection, etc). Of course, the overwhelming majority of patients experiencing intra-operative right or left ventricular failure can be treated with a combination of inotropes and nitric oxide inhalation. However, others lack sufficient ventricular function to provide adequate delivery of oxygenated blood to the tissues. Such patients readily develop renal dysfunction, acidosis, and ultimately die from cardiogenic shock unless provided mechanical assistance to support or replace the heart's pump function. This chapter reviews the anesthetic management of patients in need of intra-aortic balloon counterpulsation, (IABP) ventricular assist devices (VADs), and heart transplantation (HT). SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/11/12 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=8551121 ER -