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Anaesthesia for heart transplantation 

Anaesthesia for heart transplantation
Chapter:
Anaesthesia for heart transplantation
Author(s):

Andy Gaunt

and Nandor Marczin

DOI:
10.1093/med/9780199653478.003.0023
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date: 15 October 2019

The chapter provides an overview on the issues related to heart transplantation. It includes a wide analysis of the relevant problems related to the recipient (indications, pre-transplant evaluation and treatment) and the donor (suitability, assessment of the donor’s heart; minimization of the ischaemic time; transport and preservation of the donor’s heart). Subsequently, the operative part of the heart transplant is analysed, including the preoperative and intraoperative management of the recipient, haemodynamic monitoring, and coagulation management. The technical process of a heart transplant is described. Weaning from cardiopulmonary bypass is extensively treated, as well as the main haemodynamic problems that may be faced immediately after the surgical procedure, in the operating room, and in the early hours after admission in the intensive care unit. Left and right ventricular failure that may complicate the procedure are described in terms of haemodynamic pattern, diagnosis, and pharmacological treatment or mechanical assistance.

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