Book © 2021

Softcover ISBN978-3-030-47886-5

Edition Number1

Number of PagesXIII, 769

Number of Illustrations71 b/w illustrations, 131 illustrations in colour

 TOPICS: Anesthesiology , Cardiac Surgery

• Covers all current cardiac surgery procedures
• Written by an international panel of experts in anesthesia and surgery

About this book

This comprehensive yet concise book addresses current best practice in the combined areas of cardiac surgery and anesthesia, interventional minimally invasive cardiac procedures, perioperative management and monitoring, and critical care recovery.

This book not only provides the latest best practices in the perioperative management of cardiac surgical patients, but also it summarizes the current clinical guidelines and algorithms from leading cardiac programs and professional societies.

Contemporary best practice approaches are written by experts from leading cardiac surgical centers. The preoperative, intraoperative and postoperative management and recovery of surgical patients, including medication, monitoring techniques, and innovative surgical procedures, are presented by experts in the field of cardiac anesthesia and surgery. Perioperative clinical care guidelines, postoperative recovery pathways and models of care are presented with supporting protocols.

Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery is aimed at all cardiac anesthesiology consultants, fellows, and trainees; all cardiac surgery consultants, fellows, and trainees; nurses in perioperative care and those involved in patient recovery management; cardiac program administrative professionals; and all critical care consultants and trainees looking after cardiovascular surgical patients in the modern era.

Keywords

Cardiac anesthesia – cardiac surgery – perioperative care – preoperative optimization  – intraoperative monitoring and management postoperative care and recovery

Table of contents (62 chapters)

Front Matter

Pages i-xiii

Introduction

Front Matter

Pages 1-1

Overview of a Modern Cardiac Surgical Centre

Tirone David

Pages 3-4

Prognostic Risks and Preoperative Assessment

Karim S. Ladha, Duminda N. Wijeysundera

Pages 5-15

Perioperative Anesthesia Techniques and Management

Front Matter

Pages 17-17

Perioperative Management of Cardiac Surgical Patients Receiving Antithrombotic Agents

Pulkit Bhuptani, Alexander T. H. Suen, C. David Mazer

Pages 19-32

Fast-Track Cardiac Anesthesia and Early Tracheal Extubation

Janet Martin, Davy C. H. Cheng

Pages 33-39

Anesthetic Management in Robotic Hybrid Coronary Artery Bypass Surgery

Keita Sato, Daniel Bainbridge

Pages 41-49

Anesthetic Management in On-Pump Valvular Heart Surgery

Steven Konstadt, Walter Bethune, Jason Fu

Pages 51-60

Anesthetic Management for Transcatheter Aortic Valve Implantation (TAVI)

Lachlan F. Miles, Andrew A. Klein

Pages 61-72

Anesthetic Considerations for Non-Robotic-and Robotic Minimally Invasive Mitral Valve Surgery

1. Ackermann, W. Zakhary, J. Ender

Pages 73-85

Anesthetic Management in Aortic Arch Surgery and Neuroprotection

Alexander J. Gregory, Albert T. Cheung

Pages 87-110

Anesthetic Management in Open Descending Thoracic Aorta Surgery

Sreekanth Cheruku, Amanda Fox

Pages 111-122

Anesthetic Management of Thoracic Endovascular Aortic Repair

Mariya Geube, Christopher Troianos

Pages 123-138

Non-Operating Room Anesthesia for Electrophysiology Procedures

Janet Martin, Davy C. H. Cheng

Pages 139-148

Anesthesia for Combined Cardiac and Thoracic Procedures

Nathan Ludwig, Marcin Wasowicz, Peter Slinger

Pages 149-160

Anesthetic Management of Heart Transplantation

1. Stéphane Lambert, Mark Hynes

Pages 161-169

The LVAD-Supported Patient Presenting for Non-Cardiac Surgery

Marc E. Stone, Tanaya Sparkle

Pages 171-186

Anesthesia in Pediatric Cardiac Surgery

Eric L. Vu, Pablo Motta

Pages 187-197

Congenital Heart Disease and the Adult for Cardiac Surgery and Cardiac Intervention

Jane Heggie

Pages 199-208

Perioperative Anesthesia Techniques and Management

Anesthetic Management of Cardiac Surgery Patients with Uncommon Diseases

Carlos Galhardo Jr., Mauricio Daher

Pages 209-223

Essence of Cardiopulmonary Bypass Circuit and Intra-Aortic Balloon Pump

Jodie Beuth, George Djaiani

Pages 225-234

Essence of Pacemakers and Its Application After CPB

Nathan Waldron, Joseph Mathew

Pages 235-248

Weaning from CPB

Annette Vegas

Pages 249-258

Pulmonary Hypertension and Right Ventricular Dysfunction Post-Cardiopulmonary Bypass

Etienne J. Couture, Mahsa Elmi-Sarabi, William Beaubien-Souligny, André Denault

Pages 259-272

Perioperative Blood Management in Cardiac Surgery

Nadia B. Hensley, Megan P. Kostibas, Colleen G. Koch, Steven M. Frank

Pages 273-286

Perioperative Antifibrinolytics and Coagulation Management

John Fitzgerald, Aidan Sharkey, Keyvan Karkouti

Pages 287-296

Heparin-Induced Thrombocytopenia and Alternatives to Heparin

Linda Shore-Lesserson, Alan Finley

Pages 297-301

Perioperative Management of Cardiac Surgical Emergency

Nian Chih Hwang, Priscilla Hui Yi Phoon

Pages 303-313

Regional Anesthesia Techniques and Management in Cardiothoracic Surgery

Jodie Beuth, George Djaiani

Pages 315-320

Perioperative Monitoring Technology and Management

Front Matter

Pages 321-321

Spinal Cord Ischemia Monitoring and Protection

Albert T. Cheung, Jaime R. López

Pages 323-343

Neuromonitoring During Cardiac Surgery

Choy Lewis, Suraj D. Parulkar, John Bebawy, Charles W. Hogue

Pages 345-355

Perioperative Monitoring Technology and Management: Coagulation Monitoring Technologies and Techniques

Pascal Colson, Seema Agarwal, Aamer Ahmed, On behalf of Haemostasis and Transfusion EACTA Subcommittee

Pages 357-367

Perioperative Transesophageal Echocardiography in Cardiac Surgery Procedures

Annette Vegas

Pages 369-380

Echocardiography for Structural Heart Disease Procedures

Stanton K. Shernan

Pages 381-398

Perioperative Transthoracic Echocardiography

1. E. Chee, H. B. Song

Pages 399-422

Myocardial Protection During Cardiac Surgery

Amine Mazine, Myunghyun M. Lee, Terrence M. Yau

Pages 423-432

Surgical Technique and Postoperative Considerations

Front Matter

Pages 433-433

On-Pump and Off-Pump Coronary Revascularization Surgery

Louay M. Habbab, André Lamy

Pages 435-448

Surgical Technique and Postoperative Considerations

Robotic Coronary Artery Revascularization

Bob Kiaii

Pages 449-458

Surgery of the Aortic Valve and Root

Tirone David

Pages 459-470

Surgery of the Mitral Valve

Tirone David

Pages 471-480

Tricuspid Valve Surgery

Tirone David

Pages 481-484

Robotic Cardiac Valvular Surgery

Bob Kiaii

Pages 485-489

Circulatory Arrest and Cerebral Protection Strategies

Christopher L. Tarola, Michael W. A. Chu

Pages 491-500

Aortic Arch Reconstructive Surgery

Matthew Valdis, Olivia Ginty, Michael W. A. Chu

Pages 501-509

Surgery of Descending Thoracic Aorta

Martin Misfeld, Khalil Jawad, Michael A. Borger

Pages 511-516

Combined Cardiac and Vascular Surgery

Piroze Davierwala, Alexandro Hoyer, Michael A. Borger

Pages 517-522

Surgery for Mechanical Complications of Myocardial Infarction

Tirone David

Pages 523-527

Surgery for End-Stage Heart Disease and Heart Transplantation

Vivek Rao

Pages 529-536

Lung and Heart-Lung Transplantation: Surgical Technique and Postoperative Considerations

Andrea Mariscal, Marcelo Cypel, Shaf Keshavjee

Pages 537-546

Ventricular Assist Devices

Vivek Rao

Pages 547-553

Left Ventricular Aneurysm

Tirone David

Pages 555-557

Cardiac Surgical Recovery Unit and Postoperative Complications

Front Matter

Pages 559-559

Fast Track and Ultra-Fast Track Cardiac Surgery Recovery Care

Janet Martin, Daniel Bainbridge, Davy C. H. Cheng

Pages 561-570

Atrial and Ventricular Arrhythmia Management

Yatin Mehta, Dheeraj Arora

Pages 571-580

Cardiac Surgery Advanced Life Support (CS-ALS)

Osama Sefein, Jeff Granton, Dave Nagpal, Cheryl Kee, Jian Ray Zhou

Pages 581-588

Tamponade and Chest Re-opening

Amit Korach, Benjamin Drenger

Pages 589-596

Renal Failure and Dialysis

Anne D. Cherry, Benjamin Y. Andrew, Jamie R. Privratsky, Mark Stafford-Smith

Pages 597-618

Cardiac Surgical Recovery Unit and Postoperative Complications

Neurologic Complications After Cardiac Surgery: Stroke, Delirium, Postoperative Cognitive Dysfunction, and Peripheral Neuropathy

Janet Martin, Davy C. H. Cheng

Pages 619-636

Difficult Weaning from Mechanical Ventilation and Tracheotomy Care

Martin Lenihan, George Djaiani

Pages 637-643

Infection, Sternal Debridement and Muscle Flap

Amine Mazine, Stefan O. P. Hofer, Terrence M. Yau

Pages 645-653

Postoperative Surgical Ward and Rehabilitation Management

Front Matter

Pages 655-655

Palliative Care Post Cardiac Surgery

Valerie Schulz, Teneille Gofton

Pages 657-664

Routine Surgical Ward Care and Discharge Planning

Anthony Ralph-Edwards

Pages 665-669

Ward Complications and Management

Dave Nagpal, Sanjay Asopa

Pages 671-678

Pain Management After Cardiac Surgery

Kevin Armstrong, Qutaiba A. Tawfic

Pages 679-686

Post Cardiac Surgery Rehabilitation

Neville Suskin, Charles Faubert, Robert McKelvie

Pages 687-696

Back Matter

Pages 697-769

Cardiac Surgical Recovery Unit and Postoperative Complications

Neurologic Complications After Cardiac Surgery: Stroke, Delirium, Postoperative Cognitive Dysfunction, and Peripheral Neuropathy

Janet Martin, Davy C. H. Cheng

Pages 619-636

Difficult Weaning from Mechanical Ventilation and Tracheotomy Care

Martin Lenihan, George Djaiani

Pages 637-643

Infection, Sternal Debridement and Muscle Flap

Amine Mazine, Stefan O. P. Hofer, Terrence M. Yau

Pages 645-653

Postoperative Surgical Ward and Rehabilitation Management

Front Matter

Pages 655-655

Palliative Care Post Cardiac Surgery

Valerie Schulz, Teneille Gofton

Pages 657-664

Routine Surgical Ward Care and Discharge Planning

Anthony Ralph-Edwards

Pages 665-669

Ward Complications and Management

Dave Nagpal, Sanjay Asopa

Pages 671-678

Pain Management After Cardiac Surgery

Kevin Armstrong, Qutaiba A. Tawfic

Pages 679-686

Post Cardiac Surgery Rehabilitation

Neville Suskin, Charles Faubert, Robert McKelvie

Pages 687-696

Back Matter

Pages 697-769

Editors and Affiliations

Davy C.H. Cheng

Distinguished University Professor Department of Anesthesia and Perioperative Medicine and Department of MedicineDivision of Critical Care Medicine, London Health Sciences Center and St Joseph’s Healthcare London Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, Canada

Janet Martin

Associate Professor Department of Anesthesia and Perioperative Medicine and Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, Canada

Tirone David

Professor of Surgery University of Toronto, Melanie Munk Chair of Cardiovascular Surgery University Health Network, Toronto, Canada

About the editors

Davy C. H. Cheng, MD, MSc, FRCPC, FCAHS, CCPE

Dr. Davy Cheng is a Distinguished University Professor and Former Acting Dean of Schulich School of Medicine & Dentistry, Western University. He holds the Chair in Evidence-based Perioperative Clinical Outcomes Research (EPiCOR) and is the co-founder and Medical Director of the Centre for MEDICI (Medical Evidence, Decision Integrity, Clinical Impact), which is a World Health Organization (WHO) Collaborating Center in the study of global surgery, anesthesia & perioperative care. Dr. Cheng served as the Chair / Chief of the Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care London, and Western University from 2001-2017. Dr. Cheng is also the founding Medical Director of the Cardiac Surgery Recovery Unit (2002), Critical Care Western, Department of Medicine.

Dr. Cheng graduated from the Faculty of Medicine, University of Toronto in 1983 and completed his internal medicine internship and anesthesia residency in 1987. He joined as Faculty at the Toronto Western Hospital, University of Toronto after a Clinical Research Fellowship in 1988 and a Cardiovascular Anesthesia Fellowship at the University of Iowa Hospitals and Clinics, Iowa City in 1989. Prior to his appointment in 2001 at Western University, London, Dr. Cheng held the position of Professor and Deputy Chief of Anesthesiology at the Toronto General Hospital, University of Toronto and as Medical Director, Cardiovascular Surgery Program, University Health Network (UHN), Toronto.

Dr. Cheng is a globally recognized healthcare leader in the forefront of research, practice and healthcare policy in the fields of perioperative medicine, cardiac surgery, critical care medicine, and evidence-based clinical decision-making. His pioneer work in fast track cardiac anesthesia and recovery has established the standard of cardiac anesthesia and recovery practice around the world(citations 10,544, h-index 54, i10-index 122). He co-chaired the Steering Committee and Expert Consensus Panel for the International Society for Minimally Invasive Cardiac Surgery (ISMICS), the European Association of Cardiothoracic Society (EACTS), as well as the World Health Organization (WHO) in practice guideline development.

Janet E. Martin, BSc(Phm), PharmD, MSc(HTA&M), PhDeq

Dr. Janet Martin is an Associate Professor of Anesthesia & Perioperative Medicine and Epidemiology & Biostatistics at Schulich School of Medicine & Dentistry, Western University, London, Canada. She is also Director of the Centre for Medical Evidence, Decision Integrity & Clinical Impact (MEDICI), and Co-Director of the WHO Collaborating Centre for Global Surgery, Anesthesia & Perioperative Care.

Dr. Martin is recognized for leadership in clinical epidemiology, evidence synthesis, health technology assessment, and knowledge translation, especially as it relates to improving access to safe surgery, anesthesia and perioperative care in high-, middle- and low-income countries. Dr. Martin commonly serves as policy advisor for decisions related to public access to drugs, perioperative procedures, devices and technologies at the provincial and national level in Canada, and internationally. She has collaborated with more than 25 countries on global health issues, including priority-setting for universal healthcare, improving cost-effectiveness of care, and improving the value of local and global research. Dr. Martin provides case-based workshops and courses on “evidence-based medicine”, “clinical epidemiology”, “difficult decision-making in healthcare” in Canada, Europe, Asia, and Africa. She has published over 150 papers, 18 guidelines, and co-authored 2 books (H-index 42; 8583 citations).

Tirone E. David, MD, FRCSC, OC

Dr. Tirone David is a University Professor of Surgery at the University of Toronto and the holder of the Melanie Munk Chair of Cardiovascular Surgery at the Peter Munk Cardiac Centre. Dr. David has published 365 scientific papers, 35 chapters in medical textbooks as well as 4 surgical textbooks.  He has developed numerous operative procedures to treat patients with heart valve disease, complications of myocardial infarction, and thoracic aneurysms.

One of these procedures is known as “David operation”. He has been a member of the editorial board of several medical journals.

Dr. David is a member of numerous surgical and medical societies and is honorary member of the European Cardio-Thoracic Association, the Brazilian Cardiovascular Society, Italian Society for Cardiac Surgery, Southern Thoracic Surgical Association, German Society for Thoracic and Cardiovascular, Society of Cardiac Surgeons, and Japanese Association for Thoracic Surgery.

Dr. David was elected honorary member of the Brazilian National Academy of Medicine in 2013. He was President of the American Association for Thoracic Surgery in 2004-2005 and the recipient of its Scientific Achievement Award in 2016. He received the Order of Ontario in 1993 and the Order of Canada in 1996, the highest honor given to civilians in Canada. He was elected University Professor in 2004, the highest honor the University of Toronto bestows to its professors.