Cardiovascular & Thoracic Anesthesia

Recommended Readings

Hematologic Considerations in Cardiac Surgery

Horrow, J: Transfusion Medicine and Coagulation Disorders. Management of Cardiopulmonary Bypass and Associated Problems. In Cardiac Anesthesia, Kaplan, JA (Editor) Philadelphia, Saunders, 2000.

Although the Kaplan text is too robust for an anesthesia resident, the chapters by Horrow and Mora should be mastered.

Management of Cardiopulmonary Bypass

Mora Mangano, C, et al: Cardiopulmonary Bypass and the Anesthesiologist. Management of Cardiopulmonary Bypass and Associated Problems. In Cardiac Anesthesia, Kaplan, JA (Editor) Philadelphia, Saunders, 2000.

Valvular Heart Disease

Chambers, DA: Acquired Valvular Heart Disease. Cardiac Anesthesia. New York, Grune & Stratton, 1979.

Some things never change. This is the most succinct, clear, yet complete discussion of valvular heart disease and the implications for the cardiac anesthesiologist that I have found over the last twenty years.

Acid-Base Management and CPB

Hickey, P, Hansen, DD: Temperature and Blood Gases: The Clinical Dilemma of Acid - Base Management for Hypothermic Cardiopulmonary Bypass.

Cardiopulmonary Bypass: Current Concepts and Controversies. Philadelphia, WB Saunders Company, 1989.

You must master the topic of alpha-STAT vs. ph-STAT acid base management in cardiac surgery.

Priestley, MA, et al: Surgery for Congenital Heart Disease. The Journal of Thoracic and Cardiovascular Surgery 121:2, 2001.

Jonas, RA: Optimal pH Strategy for Hypothermic Circulatory Arrest. The Journal of Thoracic and Cardiovascular Surgery 121:2, 2001.

If you understand this article, you have mastered the concept of acid-base management under various temperature conditions.

O’Connor, CJ, Rothenberg, DM: Anesthetic Considerations for Descending Thoracic Aortic Surgery: Parts 1 and 2. Journal of Cardiothoracic and Vascular Anesthesia 9:5 & 6, 1995.

You will enjoy a substantial experience in descending aortic surgery at Stanford University Hospital.

Ling, E, et al: Systematic Overview of the Evidence Supporting the Use of Cerebrospinal Fluid Drainage in Thoracoabdominal Aneurysm Surgery for Prevention of Paraplegia. Anesthesiology 93:4, 2000.

You will place many sub-arachnoid drains; understood the rationale for their use.

Neri, E, et al: Operation for Acute Type A Aortic Dissection in Octogenarians: Is It Justified? The Journal of Thoracic and Cardiovascular Surgery 121:2, 2001.

More than philosophical considerations for your practice.

Endovascular Stents for the Treatment of Diseases of the Aorta

Dake, MD, et al: Endovascular Stent-Graft Placement for the Treatment of Acute Aortic Dissection. The New England Journal of Medicine 340:20, 1999.

Dake and colleagues pioneered this technology at Stanford. We continue to care for patients managed with this technology.

Implantable Defibrillators

Atlee, JF, Bernstein, AD: Cardiac Rhythm Management Devices: Parts 1 and 2. Anesthesiology 95, 2001. Understanding AICDs.

Outcomes in Cardiac Surgery Patients

Roach, GW, et al: Adverse Cerebral Outcomes After Coronary Bypass Surgery. The New England Journal of Medicine 335:25, 1996.

Mora Mangano, CT, et al: Renal dysfunction after myocardial revascularization: Risk factors, adverse outcomes, and hospital resource utilization. Annual Internal Medicine 128:194-203, 1998.

Ventricular Assist Devices

Goldstein, DJ, et al: Implantable Left Ventricular Assist Devices. The New England Journal of Medicine 339:21, 1998.

We provide anesthesia for an increasingly debilitated group of patients managed with these devices.

Anesthesia for High Risk Patients Undergoing Non-Cardiac Surgery

Mangano, D: Cardiovascular Morbidity Associated with Surgery: Perspectives and New Findings. Annals of Cardiac Anesthesia 2:1-36, 1998.

Overview of perioperative care for high-risk patients undergoing non-cardiac surgery.

Transesophageal Echocardiography

Shanewise, JS, et al: ASE/SCA Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal Echocardiography Examination. Anesth Analg 89:870-84, 1999.

Nishimura RA, et al. Evaluation of Diastolic Filling of Left Ventricle in Health and Disease: Doppler Echocardiography is the Clinician’s Rosetta Stone. JACC Vol. 30. No.1 July 1997: 8-18.

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