Pearls and pitfalls in managing right heart failure in cardiac surgery.

Abstract

PURPOSE OF REVIEW:

To review the recent insights in the evaluation and management of perioperative (RHF).

RECENT FINDINGS:

Recent studies highlight the potential role of myocardial deformation imaging in the evaluation of patients at risk of postoperative RHF. There is also a growing interest to study the value of load-adaptation indices of the right heart in the setting of pulmonary hypertension or left ventricular assist device implantation. Finally, the field of temporary extracorporeal life support devices for RHF is rapidly evolving and new strategies are emerging.

SUMMARY:

An integrated approach for assessing the cardiopulmonary axis combining imaging, hemodynamic and tissue perfusion monitoring is emerging, as particularly helpful in the field. Several developments in the field of temporary right heart support including the pumpless interventional lung assist membrane ventilator are offering new opportunities to support the right-heart pulmonary circulation. Future multicenter studies are needed to develop more effective preventive and therapeutic strategies for RHF.

• Authors: Francois Haddad, Mahsa Elmi-Sarabi, Elie Fadel, Olaf Mercier, Andre Y Denault
• Journal: Current opinion in anaesthesiology (Curr Opin Anaesthesiol) Vol. 29 Issue 1 Pg. 68-79 (Feb 2016) ISSN: 1473-6500 [Electronic] United States
• PMID: 26658183 (Publication Type: Journal Article, Review)

Topics

• Cardiac Surgical Procedures
• Heart Failure (diagnosis, prevention & control, therapy)
• Heart-Assist Devices
• Humans
• Intraoperative Complications (diagnosis, prevention & control, therapy)
• Monitoring, Physiologic (methods)
• Postoperative Complications (diagnosis, prevention & control, therapy)