The Cardiac Surgical Patient
KEY POINTS 1. Inability to climb two flights of stairs showed a positive predictive value of 82% for postoperative pulmonary or cardiac complications. 2. Silent ischemia is more common in…
Transesophageal Echocardiography
KEY POINTS 1. The majority of cardiac surgical transesophageal echocardiography (TEE) imaging uses 2-dimensions, which is accomplished via phased array transducers consisting of 64 to 128 small crystals activated sequentially….
Anesthetic Considerations for Patients with Pericardial Disease
KEY POINTS 1. Despite the many and varied etiologies, the manifestations of pericardial disease are primarily expressed as pericardial effusion, inflammation, and constriction. The common theme is impaired cardiac filling…
Cardiopulmonary Bypass: Equipment, Circuits, and Pathophysiology
KEY POINTS 1. The goal of cardiopulmonary bypass is to provide adequate gas exchange, oxygen delivery, systemic blood flow with adequate perfusion pressure while minimizing the detrimental effects of bypass….
Anesthetic Management for Patients with Congenital Heart Disease: The Adult Population
KEY POINTS 1. In adult CHD, a clinically relevant classification of lesions into three categories is useful: (1) Complete surgical correction, (2) partial surgical correction or palliation, and (iii) uncorrected…
Arrhythmia, Rhythm Management Devices, and Catheter and Surgical Ablation
KEY POINTS 1. Patients with moderate to severe left ventricular dysfunction are at a higher risk for sustained monomorphic VT than those with preserved left ventricular function. 2. VT more…
Anesthetic Management of Cardiac Transplantation
KEY POINTS 1. Nonischemic cardiomyopathy (53%) is the most common pretransplant diagnosis worldwide. 2. Nearly 70% of recipients in the United States require some form of life support prior to…
Anesthetic Management of Myocardial Revascularization
KEY POINTS 1. The total annual cost of cardiovascular disease in the U.S. is close to 400 billion representing 17% of the total health care costs due to major illness….
Alternative Approaches to Cardiac Surgery with and without Cardiopulmonary Bypass
KEY POINTS 1. Off-pump coronary artery bypass grafting (OPCAB) challenges the anesthesiologist and surgeon to maintain hemodynamic stability while delicate coronary arterial anastomoses are performed on a beating heart. 2….
Postoperative Care of the Cardiac Surgical Patient
KEY POINTS 1. Transport from the operating room (OR) to the intensive care unit (ICU) is a critical period for patient monitoring or vigilance. Emergency drugs and airway equipment should…
