Management after Cardiopulmonary Bypass

Most transplanted hearts depend on the exogenous administration of catechola-mines for the first few days after transplantation. Therefore, their administration should not be interrupted at any point, especially during and immediately after the transfer of the patient to the intensive care unit.

Biventricular failure immediately after transplantation can be the result of inadequate preservation or hyperacute rejection, and may require inotropic support, biventricular assist device, or artificial heart. Right ventricular failure can be seen in patients with mild-moderate pulmonary hypertension. Excessive volume loading should be avoided; maintaining perfusion of the right ventricle by optimizing blood pressure and inotropic support is essential. A right ventricular assist device may be required.

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