Anesthesia for Heart Transplantation

Abstract

Although several new surgical therapies hold promise for changing the surgical approach to heart failure, the most effective therapy currently for patients with end- stage congestive heart failure is heart transplantation. The challenges posed to the anesthesiologist caring for these patients are great, and are increasing as a result of a shift toward transplanting medically unstable pa tients. The anesthetic management of patients undergo ing heart transplantation requires a knowledge of the pathophysiology of heart failure, the altered pharmacody namics of anesthetics in the patient with heart failure, treatment of right heart failure, as well as the impact of new surgical therapies on cardiovascular function.