TY - CHAP M1 - Book, Section TI - Chapter 5. The Complicated Patient for Cardiac Anesthesia and Surgery A1 - Wasnick, John D. A1 - Hillel, Zak A1 - Kramer, David A1 - Littwin, Sanford A1 - Nicoara, Alina Y1 - 2011 N1 - T2 - Cardiac Anesthesia and Transesophageal Echocardiography AB - The elective patient for cardiac anesthesia and surgery free of other disease processes is increasingly a rara avis. Prior to advances in percutaneous interventions, the routine cardiac surgery patient was an otherwise healthy middle-aged man in need of a one to two vessel coronary artery bypass—How times have changed. Today's cardiac surgery patient is likely to be quite elderly with multiple medical problems presenting for combined revascularization and valvular replacement surgery. Moreover, many patients will have had over the course of their lives other cardiac procedures including previous operations and/or percutaneous interventions. Further complicating matters, many of these patients suffer from systolic and diastolic dysfunction, some with remarkably low ejection fractions to less than 20%. Consequently, the "healthy" patient for heart surgery is an oxymoron. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/04/19 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=8550531 ER -