[Anesthetic management for left ventricular assist device implantation in patients waiting for heart transplantation].
We report the anesthetic management of patients with dilated cardiomyopathy who underwent left ventricular assist device implantation (LVAD). Anesthesia was induced and maintained with midazolam and fentanyl. Transesophageal echocardiography (TEE) and a PA catheter were useful for hemodynamic monitoring and management of the patients. Furthermore, TEE is useful for the early detection of inflow of the air which is absorbed by negative pressure derived from high LVAD support pressure. On starting LVAD support, evaluation of right ventricular function and treatment for right ventricular failure were important and necessary for the patients. Added to conventional therapy using catecholamines, inhaled nitric oxide may provide a favorable effect for right ventricular failure.
Department of Anesthesiology, University of Tsukuba, Tsukuba 305-0006.
S
S
Nakayama
S
S
Inomata
H
H
Furukawa
N
N
Okubo
M
M
Miyabe
H
H
Toyooka
D000328:Adult; D000758:Anesthesia; D002311:Cardiomyopathy, Dilated / Q000628:therapy; D002407:Catheterization, Swan-Ganz; D017548:Echocardiography, Transesophageal; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000628:therapy