[Perioperative heart failure - anesthetic management and monitoring]

Due to the demographic and medical development, the number of patients with heart failure needing anaesthesiological care will continue to grow in the upcoming years. For the optimal care of these patients close coordination between the surgically treating, the cardiology and the anesthesiological department is important. Cardiac function and structural characters, such as cardiac valve defects should be known preoperatively. Thus, the anaesthetic management, intraoperative monitoring, as well as necessary pharmacological interventions can be tailored. Especially in high-risk patients goal directed hemodynamic therapy is useful. For this, in addition to the established monitoring procedures, less invasive monitoring devices areincreasingly used. During an acutehaemodynamic instability, thetransoesophageal echocardiography is gaining importance due to its wide diagnostic evaluation.