Anestesia para cirugía no cardíaca en paciente post-trasplantado cardíaco.revisión y puesta al día, a propósito de un caso
- García Sáiz, Irene
- Muñoz, F.
- Gómez Herreras, José Ignacio
- Aldecoa Alvarez de Santullano, César
ISSN: 1139-8264
Année de publication: 2014
Volumen: 17
Número: 1
Pages: 39-45
Type: Article
D'autres publications dans: Revista española de investigaciones quirúrgicas
Résumé
Recipients of heart transplant undergo more often noncardiac surgical procedures nowadays. The increased survival of this population in recent years is due to the decrease in rejection with the introduction of immunosuppressive therapy. It is essential for the anesthesiologist to understand the physiological and pharmacological implications in the atypical heart and the immunosuppressed body. The transplanted heart is denervated, and modulation of cardiac output mainly depends on the increase in stroke volume according to the Frank- Starling law. During anesthesia, an adequate preload, strict aseptic conditions and the use of drugs with direct action on the myocardium must be ensured. Perioperative anesthetic aspects of the transplanted patient are reviewed, and a case that came to our hospital and underwent revascularization of lower limb under spinal anesthesia is reported.