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This chapter begins with a review of the indications for heart transplantation, then presents recipient evaluation and pretransplant management. Then, donor management, surgical technique, and anesthetic management are discussed. Immunosuppression and rejection therapy are then summarized. Next, heterotopic heart transplantation, combined heart and liver transplantation, and retransplantation are...
Pulmonary hypertension (PH) is a multifactorial disease requiring thorough evaluation and classification followed by focused therapy. Several factors associated with the perioperative period are potential triggers for a pulmonary hypertensive crisis, and patients with PH have significant risks of cardiac arrest or death. Safe and successful anesthetic management of these patients requires understanding...
Surgical management of congenital cardiac disease in children produces a profound insult to immature organ systems. Because of the size of the cardiopulmonary bypass circuit is relatively larger in children as compared to adults, there is greater blood exposure to the artificial surface and more significant hemodilution producing a profound inflammatory response and activation of the coagulation cascade...
Managing the airway and optimizing ventilation for children with congenital heart disease can be particularly challenging tasks. Even though many patients require prolonged periods of tracheal intubation, evidence of laryngeal and tracheal injury is very low, and the use of cuffed endotracheal tubes does not appear to increase this risk. In addition, cuffed endotracheal tubes provide a significant...
Young and mature adults living with CHD often regard themselves as normal persons that happen to have had a heart problem in the past. They frequently are followed by a pediatric cardiologist, who, for a variety of reasons, both patient and system related, has not transitioned their care to an adult cardiologist and a network of adult consultants. The number of adults living with congenital heart...
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