Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary ar...Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery(PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures. Some devices, such as the CardioM EMS and thoracic impedance monitors present as part of implantable cardiac defibrillators, are supported by a body of evidence which show the potential to reduce HF related morbidity and have received regulatory approval, whereas other devices have failed to show benefit and, in some cases, harm. Clearly these devices can convey a considerable amount of information and clinicians should start to familiarize themselves with their use and expect further development and refinement in the future.展开更多
BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56...BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56-year-old male patient with dilated cardiomyopathy undergoing an EVAHEART implantation.Transesophageal echocardiography is crucial to ensure the correct positioning of the device and the proper aortic valve outflow.Because the continuous blood flow device functions best under low systemic and pulmonary vascular resistance,milrinone is the preferred drug.Our patient was accompanied by pulmonary hypertension,so during the operation,nitric oxide was used to reduce pulmonary artery pressure.CONCLUSION The cardiac output achieved by the patient with the assistance of EVAHEART can reach 4 L/min,which of course depends on the front load,rear load,and pump speed.展开更多
文摘Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery(PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures. Some devices, such as the CardioM EMS and thoracic impedance monitors present as part of implantable cardiac defibrillators, are supported by a body of evidence which show the potential to reduce HF related morbidity and have received regulatory approval, whereas other devices have failed to show benefit and, in some cases, harm. Clearly these devices can convey a considerable amount of information and clinicians should start to familiarize themselves with their use and expect further development and refinement in the future.
文摘BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56-year-old male patient with dilated cardiomyopathy undergoing an EVAHEART implantation.Transesophageal echocardiography is crucial to ensure the correct positioning of the device and the proper aortic valve outflow.Because the continuous blood flow device functions best under low systemic and pulmonary vascular resistance,milrinone is the preferred drug.Our patient was accompanied by pulmonary hypertension,so during the operation,nitric oxide was used to reduce pulmonary artery pressure.CONCLUSION The cardiac output achieved by the patient with the assistance of EVAHEART can reach 4 L/min,which of course depends on the front load,rear load,and pump speed.
