Thoracic Aorta
Key Points 1. Diseases of the thoracic aorta can occasionally be managed with medical treatment and surveillance, whereas others require surgical intervention. Depending on the disease process, some surgeries may…
ANESTHESIA
Long-Term Complications and Management
Key Points 1. Cardiac surgical patients are at significant risk from preventable adverse events. These events occur through human error, by either faulty decision making (diagnosis, decision for treatment) or…
Central Nervous System Dysfunction After Cardiopulmonary Bypass
Key Points 1. Despite a progressive decrease in cardiac surgical mortality, the incidence of postoperative neurologic complications has remained relatively unchanged over the decades. 2. The risk for stroke in…
Cardiopulmonary Bypass Management and Organ Protection
Key Points 1. Cardiopulmonary bypass (CPB) is associated with a number of profound physiologic perturbations. The central nervous system, kidneys, gut, and heart are especially vulnerable to ischemic events associated…
Postoperative Respiratory Care
Key Points 1. Cardiac anesthesia has fundamentally shifted from a high-dose narcotic technique to a more balanced approach using moderate-dose narcotics, shorter-acting muscle relaxants, and volatile anesthetic agents. 2. This…
Extracorporeal Devices Including Extracorporeal Membrane Oxygenation
Key Points 1. Two predominant methods of blood propulsion are used: positive displacement roller pumps and constrained vortex centrifugal-type pumps. 2. Modern heart-lung machines are equipped with a number of…
Discontinuing Cardiopulmonary Bypass
Key Points 1. The key to successful weaning from cardiopulmonary bypass (CPB) is proper preparation. 2. After rewarming the patient, correcting any abnormal blood gases, and inflating the lungs, make…
Transfusion Medicine and Coagulation Disorders
Key Points 1. It is easiest to think of coagulation as a wave of biologic activity occurring at the site of tissue injury, consisting of initiation, acceleration, control, and lysis….
Reoperative Cardiac Surgery
Key Points 1. Reoperative cardiac surgery presents greater risk than first-time surgery because patients are usually older, have more comorbidity, and have more advanced cardiovascular disease. Also, resternotomy can be…
Patient Safety in the Cardiac Operating Room
Key Points 1. Cardiac surgical patients are at significant risk from preventable adverse events. These events occur through human error, by either faulty decision making (diagnosis, decision for treatment) or…
