What hemodynamic value should be monitored to assess the left side of the heart in a cardiovascular ICU patient after mitral-valve replacement?

Monitoring pulmonary capillary wedge pressure (PCWP) is essential to assess the left side of the heart, particularly following mitral valve replacement. PCWP provides an indirect measurement of left atrial pressure, which is crucial in evaluating left ventricular function and filling pressures. After such a surgical intervention, it is vital to ensure that the left atrium and left ventricle are effectively managing blood volume and pressure, which is reflected in the PCWP readings.

The significance of PCWP lies in its ability to indicate fluid status and cardiac performance. Elevated PCWP can signal congestion in the left heart chambers, which is particularly important for patients who have undergone mitral valve replacement, as they may be at risk for complications related to left-sided heart failure.

Mean arterial pressure primarily reflects systemic arterial pressure and does not provide specific insight into left atrial or left ventricular function. Central venous pressure is indicative of right heart function and systemic venous return, while pulmonary artery pressure assesses the pulmonary circulation rather than the left heart specifically. Hence, for evaluating the left cardiac function post-mitral valve replacement, monitoring pulmonary capillary wedge pressure is the most appropriate choice.