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.Previously Undiagnosed Patent Foramen Ovale as Cause of Hypotension and Hypoxemia in a Patient With Recent TandemHeart LVAD Insertion
DETERMINATION OF the cause of hypoxia during percutaneous left ventricular assist device (LVAD) use can be a diagnostic challenge. We present an interesting case of hypotension and hypoxemia in a patient with a TandemHeart LVAD (CardiacAssist, Inc.). The patient was a 64-year-old man with a history of ischemic cardiomyopathy, pulmonary hypertension, and coronary artery disease status post previous coronary artery bypass graft surgery. He presented with left ventricular heart failure and recurrent ventricular tachycardia and underwent ventricular tachycardia ablation assisted by planned percutaneous TandemHeart LVAD.Isolated Left Heart Tamponade on Echocardiography in Severe Pulmonary Hypertension and Right Heart Failure
Cardiac tamponade is a life-threatening condition related to fluid accumulation within the pericardial sac that impairs normal cardiac filling. As fluid accumulates in the pericardial space, pressure rises. This increase in pericardial pressure is transmitted across the transmural space, and when it exceeds intracavitary pressures, collapse of the chambers occurs. In circumferential pericardial effusions, bilateral tamponade typically occurs, and the sequence of chamber collapse corresponds with the lowest intracavitary pressures.
