Intraoperative 'pressure field' haemodynamic monitoring in a patient with severe aortic regurgitation having laparoscopic robot-assisted colorectal surgery
- Author(s)
- Martis, WR; Allen, C; Ahmed, R; Ismail, H; Woodford, S; Riedel, B;
- Details
- Publication Year 2024-10-17,Volume 52,Issue #6,Page 420-426
- Journal Title
- Anaesthesia and Intensive Care
- Publication Type
- Case report
- Abstract
- Laparoscopic robot-assisted colorectal surgery can pose significant haemodynamic challenges for patients with severe aortic regurgitation. The increased afterload caused by pneumoperitoneum and aortic compression, along with concurrent factors like hypercarbia, Trendelenburg positioning and ventilatory impairment, can worsen aortic regurgitation, leading to myocardial ischaemia and heart failure. Transoesophageal echocardiography (TOE) assists haemodynamic management intraoperatively but requires subspecialist skills and enables limited inferences to be drawn regarding the impact of afterload on myocardial performance. Minimally invasive haemodynamic monitoring enabling real-time visualisation of a patient's 'pressure field' has been suggested as a potential adjunct or alternative to TOE, with the added advantage of providing continuous quantitative information about both stroke volume and the afterload to ventricular ejection in a single visualisation. We describe an example of successful concurrent use of pressure field haemodynamic monitoring and TOE in a patient with severe aortic regurgitation having a prolonged laparoscopic robot-assisted pelvic exenteration.
- Publisher
- Sage
- Keywords
- Haemodynamic monitoring; perioperative echocardiography; pressure field; robotic surgery; valvular heart disease
- Department(s)
- Anaesthetics; Surgical Oncology
- Publisher's Version
- https://doi.org/10.1177/0310057x241263115
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-11-07 06:46:37
Last Modified: 2024-11-07 06:54:52