Page 76 - Critical Care Notes

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CV
Management
Postop care is generally the same as traditional CABG surgery.

Cardiac and Cardiopulmonary Transplant
Cardiac transplant is a surgical procedure to remove a diseased heart and
replace it with a healthy donor heart. The same is true for lung transplant.
Frequently both are done together for end-stage disease of the heart and lungs
when no other therapies are viable.
End-stage heart disease includes congenital heart disease (single ventricle physiol-
ogy, coronary sinusoids), cardiomyopathy (primary: idiopathic, familial, secondary
pregnancy, drug-induced), and acquired heart disease (valvular disease).
Candidates for Heart Transplant
■ HF
■ CAD with intractable angina symptoms
■ Cardiomyopathy
■ Pulmonary hypertension with irreversible right heart failure
■ Sarcoidosis of the heart and lungs
■ Ventricular dysrhythmias unresponsive to medical or surgery therapy
■ Primary cardiac tumors with no evidence of spread to other body systems
Candidates for Lung Transplant
■ COPD (chronic obstructive pulmonary disease)
■ Cystic fibrosis
■ Idiopathic pulmonary fibrosis
■ Interstitial lung diseases
■ Primary pulmonary hypertension
Diagnostic Tests Prior to Transplantation
A battery of tests are done prior to transplantation. These may include but are
not limited to the following:
■ Echocardiogram
■ Right heart catheterization
■ Pulmonary function tests
■ Exercise treadmill test
■ Abdominal ultrasound
■ Chest x-rays
■ CT
■ Coronary angiogram
■ Cardiac biopsy
■ Chromosome testing
■ Updating of immunizations
■ Low PSA and negative Pap smear
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