right sided HF and pneumonectomy

[dfk]

---

Members do not see this ad.

ok, so...
we had a 'renowned' speaker today at grand rounds, and he was talking about pre-op assessment for thoracic surgery.
he came across a theme that when patients get pneumonectomies, they are prone to develop right sided heart failure.
his quick explanation was that the right side of the heart is 'stupid', unlike the left side.
ok, i can understand that.
abilities, concenticism, etc...
so, i got to thinking (and omitting much chatter),
does anybody think there would be any way to "train"
the right heart to get 'prepared' for pneumonectomy
in hopes of avoiding right sided HF?

 

[huktonfonix]

get your patient as hypoxic and hypercarbic for as long as possible. try to get your RV to compensate for the increased PA pressures without causing permanent remodeling of the pulmonary vasculature. Alternatively, PA banding might work with removal at pneumonectomy Other than that hopefully youve got something to decrease PVR after PA clamping. Cant think of any legitimate way to "train" the RV.

 

[Idiopathic]

yeah thats exactly what i thought of. just give them pulmonary hypertension and that should train the RH well enough.

 

[militarymd]

What was this "renowned" speaker's definition of "righted sided heart failure"?

 

[Planktonmd]

You don't train the RV for a pneumonectomy but you could do your best to improve the function and the pulmonary vascular resistance of the remaining lung by doing simple things like oxygen therapy, steroids, broncho dilators, excercise.... during the weeks before surgery.

 

[dfk]

What was this "renowned" speaker's definition of "righted sided heart failure"?

he didn't delve into the degree of RHF.
it was more of a pulmonary lecture than HF.
he basically mentioned a "downward spiral" of sorts.