Multimedia Library
Where Should We Leave the Wild “Raa Raa” During Cardiopulmonary Bypass?
THE PULMONARY artery catheter (PAC), the Raa Raa, the noisy, wild lion in a British stop-motion animated children's television program1 (Fig 1), also known as the Swan-Ganz catheter, is used frequently during cardiac surgery. The PAC might provide clinicians with important information on the preload, afterload, and contractility through the measured and derived parameters for risks stratification and guide perioperative management, particularly in patients with advanced heart failure, pulmonary hypertension, cardiogenic shock, and those who undergo heart and lung transplantation and left ventricular assist device implantation.Porcine Orthotopic Cardiac Xenotransplantation: The Role and Perspective of Anesthesiologists
ON JANUARY SEVENTH, 2022, the first genetically modified porcine cardiac xenograft was transplanted into a patient at the University of Maryland Medical Center. As members of the xenotransplant team and division of cardiac anesthesiology at the University of Maryland School of Medicine, the authors here had a role in this historic event. Cardiac xenotransplantation could become a common occurrence if it proves to be a viable answer for the limited supply of donor hearts to treat end-stage heart failure.PRO: Transesophageal Echocardiography Should Be Routinely Used for All Liver Transplant Surgeries
The anesthetic management of patients with end-stage liver disease undergoing liver transplantation (LT) surgery presents the anesthesiologist with several unique challenges. In addition to other comorbid medical conditions, patients presenting to the operating room for LT often have multiple sequelae of end-stage liver disease (ESLD), including renal dysfunction, impaired pulmonary mechanics, and coagulation defects, all of which may alter the anesthetic plan. However, management of the cardiovascular and hemodynamic characteristics of ESLD patients may be the most challenging aspect of their intraoperative care.
