Cardiac Anesthesia and Transesophageal Echocardiography

Description:

The acclaimed “must read” for anesthesiologists new to the cardiac operating room Cardiac Anesthesia & Transesophageal Echocardiography, Second Edition is a fast, proven effective way for anesthesiology trainees to acquire the essential skills and knowledge necessary to successfully navigate the cardiac operating room. Enhanced by more than 100 photographs, nearly 200 carefully rendered line drawings, and illustrative case scenarios, this unique guide imparts the basic principles of both cardiac anesthesia and echocardiography in a way that reflects the realities of clinical anesthesia practice. Included with the book is online access to nearly 100 narrated, labeled TEE clips that introduce you to both normal and abnormal echocardiographic views. Each clip is keyed to a specific passage in the text, which provides you with a true multimedia learning experience. Whether you are looking for a concise, easy-to-read introduction to cardiac anesthesiology, or a primer on incorporating the basic principles of cardiac anesthesiology and perioperative echocardiography into real-world practice, Cardiac Anesthesia & Transesophageal Echocardiography, Second Edition should be your first place to turn.

Table of Contents:

Introduction to Perioperative Echocardiography

What Can Be Learned From Perioperative Transesophageal Echocardiography (TEE)?

What Echocardiographic Modalities Are Employed and How Can They Be Used?

What Are the Indications and Contraindications for Perioperative TEE?

Briefly, How Does Echocardiography Work?

What Constitutes the Standard Perioperative TEE Examination?

How Is TEE Routinely Used Perioperatively?

What Is the Role of Three-Dimensional Echocardiography in Perioperative Management?

How Can Echocardiography Be Used to Determine Cardiac Output, Pressure Gradients, and Other Hemodynamic Measures Formerly Done With a Pulmonary Artery (PA) Catheter?

Image and Video Atlas

Chapter 1 Preoperative Evaluation of the Heart Surgery Patient

Consent for Cardiac Anesthesia

Cardiac Surgery and Teamwork

Coronary Stents or Coronary Artery Bypass?

Cardiology Evaluation

Preoperative Assessment

Preoperative Patient Care and Comfort

Chapter 2 Hemodynamics and Cardiac Anesthesia

Hemodynamic Calculations and Invasive Monitors: Why Are They Important and How Does One Determine Them?

The Pumping Heart: How Does the Pump Contract and Relax?

Pharmacology and Hemodynamics: An Introduction

TEE and Hemodynamic Instability: How TEE Advances the Diagnosis of Hypotension?

Avoiding Hemodynamic Collapse: A Case Illustration

Chapter 3 Perioperative Rhythm Abnormalities

The Electrocardiogram

ECG Abnormalities

Bradyarrhythmias

Temporary Pacemaker

Supraventricular Tachycardias

Ventricular Tachycardia and Fibrillation

TEE and the ECG

Case Scenario

Chapter 4 Routine Cardiac Surgery and Anesthesia

Immediate Preoperative Assessment and Antibiotic Prophylaxis

Monitoring and Vascular Access

Anesthetic Induction and Maintenance

Institution of Cardiopulmonary Bypass

Separation From CPB

Sternal Closure and Patient Transport

Commonly Used Vasoactive Drugs in the Cardiac Surgery Patient

Case Illustration

Summary

Chapter 5 The Complicated Patient for Cardiac Anesthesia and Surgery

The Patient With Impaired Systolic and Diastolic Ventricular Function

The Reoperative Patient

The Diabetic Patient and Perioperative Glucose Control

The Vascular Disease Patient in Need of Cardiac Surgery

The Kidney Failure Patient and Cardiac Surgery

Chapter 6 Aortic Valve Disease

Overview

The Clinical Signs and Symptoms of AV Disease

Physiologic Compensatory Mechanisms of AV Disease

Echocardiography and AV Disease

Surgical and Catheter-Mediated AV Replacement

Anesthetic Implications of AV Diseases

Clinical Scenario: The Patient With Mixed AS/AR and the Emergency Institution of CPB

Chapter 7 Mitral Valve Disease

The Clinical Signs and Symptoms of MV Diseases

Physiologic Compensatory Mechanisms of MV Diseases

Echocardiography and MV Diseases

Surgical and Catheter-Mediated Approaches to the Repair and Replacement of the MV

Surgical Approaches to the Management of Atrial Fibrillation

Anesthetic Implications of MV Diseases

Case Scenario

Chapter 8 Right Heart Valves and Function

The Clinical Signs and Symptoms of Tricuspid Valve Diseases

RV Function

The Pulmonic Valve

Echocardiography of Right Heart Structures and Right Ventricular Function

Echocardiographic Evaluation of the Tricuspid Valve and Tricuspid Regurgitation

Surgical Approaches to TV Diseases

Anesthetic Implications of TV Diseases, Pulmonary Hypertension, and RV Failure

Case Scenario: The Patient With Endocarditis

Chapter 9 Anesthesia for Repair of Diseases of Thoracic Aorta

Diseases of the Ascending Thoracic Aorta

Diseases of the Descending Thoracic Aorta

Anesthetic Management of the Patient With Disease of the Thoracic Aorta

Distal Aortic Perfusion and Spinal Cord Protection During Descending Thoracic Aneurysm Resection and Endovascular Stenting

Deep Hypothermic Circulatory Arrest

Echocardiography in the Management of Thoracic Aortic Diseases

Case Scenario

Chapter 10 Hypertrophic Obstructive Cardiomyopathy and Cardiac Masses

Signs, Symptoms, and Diagnosis of HCM

Pathology of HCM

Medical Therapy for HCM

Dynamic Obstruction of the LVOT

Anesthetic Management of the HCM Patient for Noncardiac Surgery

Anesthetic Management for Surgical Repair of HCM

The Surgical Approach to HCM Repair

Cardiac Masses

Case Scenario: 22-Year-Old Man With Sudden Cardiac Death

Chapter 11 Ventricular Assist Devices and Heart Transplantation

Intra-Aortic Balloon Counterpulsation and the Heart Surgery Patient

Ventricular Assist Devices: Designs and Indications

Short-Term VAD Placement

Long-Term VAD Placement

Anesthetic Management of VADs

TEE and VADs

Heart Transplantation

Case Scenario

Chapter 12 Anesthesia for Patients With Congenital Heart Disease

Atrial Septal Defects

Ventricular Septal Defects

Tetralogy of Fallot

Transposition of the Great Arteries

Single Ventricle Patients

Anesthesia for Noncardiac Surgery in Adults With Congenital Heart Disease

Cardiac Surgery and Pregnancy

TEE and CHD

Chapter 13 Off-Pump, Robotic, and Minimally Invasive Heart Surgery

Minimally Invasive Surgical Approaches

Anesthetic Challenges for Off-Pump and Minimally Invasive Surgery

Is Off-Pump Surgery Better Than On-Pump Surgery?

Case Scenario

Chapter 14 The Postoperative Care of the Cardiac Surgery Patient

Routine Transport and Report

Inflammation and the Cardiac Surgery Patient

Genetic Associations and Cardiac Surgery Outcomes

Perioperative Neurological Injury

Respiratory Failure

Acute Kidney Injury

ICU Hemodynamics

Analgesia, Electrolytes, Glucose

Echocardiography in the ICU

Summary

Chapter 15 Anesthesia for Electrophysiology, Hybrid, and Catheterization Procedures

Electrophysiology and Other Catheter-Based Procedures Overview

EP Procedures

Anesthetic Management of EP Procedures

Risks and Complications of Out-Of-The-OR Cardiac Procedures

Chapter 16 Coagulopathy, Bleeding, and Cardiac Anesthesia Emergencies

Hemostasis and Cardiac Surgery

Prevention of Blood Loss During Cardiac Surgery

When to Transfuse

Outcomes Following Transfusion

Massive Transfusion and Cardiac Trauma

Options for Patients Who Refuse Blood Product Administration

The Emergency Patient From the Cardiac Catheterization Laboratory

Perioperative Tamponade

Chapter 17 Cardiopulmonary Bypass

The Plumbing of CPB

Bypassing the Heart

Bypassing the Lungs

Preserving the Heart

Protecting the Brain

Electrolytes and CPB

Anticoagulation and CPB

Systemic Inflammation and CPB

Echocardiography and CPB

Extracorporeal Membrane Oxygenation (ECMO)

Chapter 18 Postoperative Analgesia for Cardiac Surgery

What Are the Systemic Implications of Pain in the Cardiac Surgery Patient?

What Modalities Are Available to Treat Postoperative Pain?

Enhanced Recovery Following Cardiac Surgery

Summary

Index