Clinical and experimental cardiovascular monitoring
Trends in cardiovascular therapies involve development of minimal invasive surgical techniques for coronary artery disease and valve repair, treatment of severe heart failure by biventricular pacing and implantation of mechanical pumps, as either bridge to transplantation or as destination therapy as an alternative to heart transplantation. Even though a method can be classified as minimal invasive, the procedural risk still may high, as demonstrated by treatment of severe aortic stenosis by catheter technique (TAVI) instead of open chest surgery. In contrast, implantation of a mechanical pump is a highly invasive procedure and use of more invasive monitoring can therefore be justified. In both cases, assessment of cardiovascular status is equally important, however, requires different approaches and must be adapted to the invasiveness of the procedure. New monitoring methods developed to assess hemodynamic status in a surgical setting may also be used to optimize treatment in hemodynamically compromised patients in the intensive care unit, such as in patients with septic shock and patients treated with therapeutic hypothermia after cardiac arrest.