RT Book, Section
A1 Wasnick, John D.
A1 Hillel, Zak
A1 Kramer, David
A1 Littwin, Sanford
A1 Nicoara, Alina
SR Print(0)
ID 8550531
T1 Chapter 5. The Complicated Patient for Cardiac Anesthesia and Surgery
T2 Cardiac Anesthesia and Transesophageal Echocardiography
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-171798-4
LK accessanesthesiology.mhmedical.com/content.aspx?aid=8550531
RD 2024/04/18
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.