KEY POINTS  1. The heart has a fibrous skeleton that provides an insertion site at each valvular ring. This fibrous structure also connects cardiac myocytes so that “stretch” or preload…

KEY POINTS  1. The incidence of ischemia during this period has been reported to be 7% to 56%.  2. The Society of Thoracic Surgeons recommends a cephalosporin as the primary…

KEY POINTS  1. Prior to cannulation for cardiopulmonary bypass (CPB), the anesthesiologist must assure that adequate heparin-induced anticoagulation has been achieved, which is typically diagnosed as an activated clotting time…

KEY POINTS  1. Core temperature (nasopharyngeal or tympanic membrane) should be greater than 36°C before terminating cardiopulmonary bypass (CPB). However, the nasopharyngeal temperature should not exceed 37°C, as this will…

KEY POINTS  1. Mechanical circulatory support devices most often are ventricular assist devices, which are indicated for bridging to myocardial recovery or cardiac transplantation or as a permanent assist device…

KEY POINTS  1. Mechanisms of myocardial ischemic injury are multifactorial and include some of the following: Depletion of high-energy phosphates, intracellular acidosis, alterations in intracellular calcium homeostasis, complement activation, generation…

KEY POINTS  1. Chronic pain due to intercostal nerve injury develops in approximately 50% of postthoracotomy patients, and in 5% this pain becomes severe and disabling.  2. Thoracic epidural analgesia…

KEY POINTS  1. On the day of surgery, most cardiovascular medications should be administered orally, with the exceptions of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and (selectively) diuretic agents….