ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

CARDIOVASCULAR ANESTHESIA

Hilal Zengin

Gülhane Training and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Türkiye

Zengin H. Cardiovascular Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.247-257.

ABSTRACT

  • In cardiac surgical cases, such as coronary artery bypass grafting (CABG), heart valve replacement, and congenital heart disease repair, cardiac anesthesia management is multidisciplinary.
  • Transesophageal echocardiography is used during cardiac surgery to confirm and enhance preoperative diagnoses, detect new or unsuspected cardiovascular pathologies that may alter anesthesia or surgical plans.
  • The initiation of cardiopulmonary bypass (CPB) is a form of extracorporeal circulation in which the patient’s blood is redirected from the heart and lungs to an external circuit.
  • Typically, cardioplegia is administered after a cross-clamp is placed on the ascending aorta. This allows surgery to be performed on a non-beating, bloodless heart. The physiological functions of the heart and lungs are temporarily taken over by the CPB machine.
  • After the surgical procedure is completed, key steps in the post-bypass phase include venous and arterial decannulation, reversal of anticoagulation with protamine administration, reinfusion of pumped blood, maintaining optimal heart function, and achieving hemostasis.
  • Patients successfully separated from CPB may show instability in the post-bypass period. The anesthesiologist must closely monitor every stage of the surgical process, be aware that issues may arise at any point, and take necessary precautions. This paper discusses the anesthesia approach applied during cardiovascular surgery.

Keywords: Cardiopulmonary bypass; General anesthesia; Anesthesia; Cardiac procedures; Hemodynamic monitoring; Transesophageal echocardiography

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