Kaplan's Cardiac Anesthesia

Kaplan's Cardiac Anesthesia

In Cardiac and Noncardiac Surgery

7th Edition - May 5, 2016

Write a review

  • Author: Joel Kaplan
  • eBook ISBN: 9780323463010
  • Hardcover ISBN: 9780323393782

Purchase options

Institutional Subscription

Free Global Shipping
No minimum order

Description

Now in a revised and expanded 7th Edition, Kaplan’s Cardiac Anesthesia helps you optimize perioperative outcomes for patients undergoing both cardiac and noncardiac surgery. Dr. Joel L. Kaplan, along with associate editors, Drs. John G. T. Augoustides, David L. Reich, and Gerard R. Manecke, guide you through today’s clinical challenges, including the newest approaches to perioperative assessment and management, state-of-the art diagnostic techniques, and cardiovascular and coronary physiology.

Key Features

  • Complete coverage of echocardiography and current monitoring techniques.
  • Guidance from today’s leaders in cardiac anesthesia, helping you avoid complications and ensure maximum patient safety.
  • More than 800 full-color illustrations.

Table of Contents

  • Cover image
  • Title Page
  • Table of Contents
  • Copyright
  • Dedication
  • Contributors
  • Preface
  • Foreword
  • A Textbook for All Anesthesiologists
  • Video Contents
  • Section I Preoperative Assessment and Management
  • 1 Assessment of Cardiac Risk and the Cardiology Consultation
  •  Sources of Perioperative Myocardial Injury in Cardiac Surgery
  •  Assessment of Perioperative Myocardial Injury in Cardiac Surgery
  •  Cardiac Risk Assessment and Cardiac Risk Stratification Models in Patients Undergoing Cardiac Surgery
  •  Specific Risk Conditions
  •  Assessment of Cardiac Risk in Patients Undergoing Noncardiac Surgery
  •  Conclusions
  • References
  • 2 Cardiovascular Imaging
  •  Echocardiography
  •  Myocardial Nuclear Scintigraphy
  •  Cardiac Computed Tomography
  •  Cardiovascular Magnetic Resonance Imaging
  •  Invasive Coronary Angiography
  •  Vascular Imaging
  •  Summary
  • References
  • 3 Cardiac Catheterization Laboratory
  •  Catheterization Laboratory Facilities: Radiation Safety and Image Acquisition
  •  Patient Selection for Catheterization
  •  Cardiac Catheterization Procedures
  •  Valvular Pathology
  •  Angiography
  •  Interventional Cardiology: Percutaneous Coronary Intervention
  •  Specific Interventional Devices
  •  Other Catheter-Based Percutaneous Therapies
  •  Other Catheter-Based Intracardiac Procedures
  •  The Catheterization Laboratory and the Anesthesiologist
  • References
  • 4 Cardiac Electrophysiology
  •  Electrophysiologic Principles
  •  Specific Arrhythmias
  •  Ventricular Arrhythmias
  •  Implantable Cardioverter-Defibrillators
  • References
  • 5 Cardiac Implantable Electrical Devices
  •  Radiology Imaging Issues
  •  Pacemakers
  •  Implantable Cardioverter-Defibrillators
  •  Summary
  •  Glossary
  •  Cautions
  • References
  • Section II Cardiovascular Physiology, Pharmacology, Molecular Biology, and Genetics
  • 6 Cardiac Physiology
  •  Functional Implications of Gross Anatomy
  •  Cardiac Myocyte Anatomy and Function
  •  Laplace's Law
  •  The Cardiac Cycle
  •  Determinants of Pump Performance
  •  Coupling, Energetics, and Efficiency
  •  Evaluation of Diastolic Function
  •  Pericardial Forces
  •  Determinants of Atrial Function
  • References
  • 7 Coronary Physiology and Atherosclerosis
  •  Anatomy and Physiology of Blood Vessels
  •  Determinants of Coronary Blood Flow
  •  Coronary Pressure-Flow Relations
  •  Atherosclerosis
  •  Pathophysiology of Coronary Blood Flow
  •  Future Directions
  • References
  • 8 Molecular and Genetic Cardiovascular Medicine
  •  Machinery Behind the Cardiac Rhythm: Ion Channels
  •  Controlling Cardiac Functioning: Receptors
  •  Anesthetic Actions
  •  Genetic Cardiovascular Medicine
  •  Acknowledgments
  • References
  • 9 Systemic Inflammation
  •  Terminology
  •  Systemic Inflammation and Cardiac Surgical Procedures
  •  Endotoxemia
  •  Splanchnic Perfusion
  •  Postoperative Complications Attributable to Inflammation
  •  Summary
  • References
  • 10 Pharmacology of Anesthetic Drugs
  •  Volatile Agents
  •  Intravenous Induction Agents
  •  Individual Agents
  •  Opioids in Cardiac Anesthesia
  •  Effects of Cardiopulmonary Bypass on Pharmacokinetics and Pharmacodynamics
  •  Acknowledgments
  • References
  • 11 Cardiovascular Pharmacology
  •  Antiischemic Drug Therapy
  •  Drug Therapy for Systemic Hypertension
  •  Pharmacotherapy for Acute and Chronic Heart Failure
  •  Pharmacotherapy for Cardiac Arrhythmias
  • References
  • Section III Monitoring
  • 12 Electrocardiographic Monitoring
  •  Historical Perspective
  •  Basic Electrophysiology and Electrical Anatomy of the Heart
  •  Electrocardiographic Changes With Myocardial Ischemia
  •  Electrocardiographic Changes With Pacemakers, Respirations, Electrolytes, and Medications
  •  Normal Electrocardiogram: Cardiac Cycle
  •  Atrial Fibrillation
  •  Atrial Flutter
  •  Atrioventricular Block
  •  Atrioventricular Dissociation
  •  Bundle Branch Block
  •  Coronary Artery Disease
  •  Digitalis Effect
  •  Electrolyte Disturbances
  •  Hypothermia
  •  Multifocal Atrial Tachycardia
  •  Paroxysmal Atrial Tachycardia
  •  Pericarditis
  •  Pericardial Tamponade
  •  Pneumothorax
  •  Premature Atrial Contraction
  •  Premature Ventricular Contraction
  •  Pulmonary Embolus
  •  Sinus Bradycardia
  •  Sinus Arrhythmia
  •  Sinus Arrest
  •  Sinus Tachycardia
  •  Subarachnoid Hemorrhage
  •  Torsades de Pointes
  •  Ventricular Fibrillation
  •  Ventricular Tachycardia
  •  Wolff-Parkinson-White Syndrome
  •  Pacing
  •  Acknowledgments
  • Bibliography
  • References
  • 13 Monitoring of the Heart and Vascular System
  •  Hemodynamic Monitoring
  •  Arterial Pressure Monitoring
  •  Central Venous Pressure Monitoring
  •  Pulmonary Arterial Pressure Monitoring
  •  Special Purpose Pulmonary Artery Catheters
  •  Cardiac Output Monitoring
  •  Left Atrial Pressure Monitoring
  •  Coronary Sinus Catheterization
  •  Analysis and Interpretation of Hemodynamic Data
  •  Pulse Oximetry
  •  Oxygen Transport Calculations
  •  Summary
  • References
  • 14 Basic Intraoperative Transesophageal Echocardiography
  •  Basic Concepts
  •  Imaging Techniques
  •  Echocardiographic Scanners
  •  Equipment
  •  Image Storage
  •  Complications
  •  Safety Guidelines and Contraindications
  •  Credentialing
  •  Technique of Probe Passage
  •  Comprehensive Intraoperative Multiplane Transesophageal Echocardiographic Examination
  •  Clinical Applications
  •  Hemodynamic Assessment
  •  Cardiac Output
  •  Contrast Applications
  •  Valvular Evaluation
  •  Myocardial Ischemia Monitoring
  • References
  • 15 Transesophageal Echocardiography
  •  The Development of a Perioperative Echocardiography Service
  •  Three-Dimensional Transesophageal Echocardiography
  •  Perioperative Echocardiographic Evaluation of Valves
  •  Transesophageal Echocardiography for Interventional Procedures
  •  Strain, Strain Rate, and Doppler Tissue Imaging
  •  Myocardial Disease
  •  Aortic Evaluation
  •  Pericardial Disease
  •  Evaluation of Cardiac Masses
  • References
  • 16 Decision Making and Perioperative Transesophageal Echocardiography
  •  Decision-Making Process
  •  Myxomatous Degeneration of the Mitral Valve and Mitral Regurgitation
  •  Management of Ischemic Mitral Regurgitation During Coronary Artery Bypass Grafting
  •  Functional Mitral Regurgitation in the Setting of Aortic Stenosis
  •  Management of Previously Undiagnosed Aortic Valve Disease
  •  Cardiac Function and New Regional Wall Motion Abnormalities
  •  Transesophageal Echocardiography as a Rescue Device: Management of Marked Hemodynamic Instability
  •  Pericardial Effusion and Cardiac Tamponade
  •  Occult Congenital Abnormalities: Persistent Left-Sided Superior Vena Cava
  •  Occult Congenital Abnormalities: Atrial Septal Defects and Patent Foramen Ovale
  •  Ascending Aorta: A Source of Embolization
  •  Case Study 2: Putting It All Together: A Case Study in Acute Aortic Syndromes
  • References
  • 17 Education and Simulation in Echocardiography
  •  Early Development
  •  Commercialization
  •  Online Learning
  •  Simulating Pathologic Conditions
  •  Evidence for Simulation
  •  Assessment
  •  Future of Echocardiography Education
  • References
  • 18 Central Nervous System Monitoring
  •  Electroencephalography
  •  Auditory-Evoked Potentials
  •  Transcranial Doppler Ultrasound
  •  Jugular Bulb Oximetry
  •  Cerebral Oximetry
  •  Multimodality Neuromonitoring
  •  Summary
  •  Disclosure and Acknowledgment
  • References
  • 19 Coagulation Monitoring
  •  Hemostasis
  •  Monitoring Heparin Effect
  •  Heparin Neutralization
  •  Tests of Coagulation
  •  Monitoring Fibrinolysis
  •  Monitoring the Thrombin Inhibitors
  •  Evaluation of Prolonged Activated Partial Thromboplastin Time
  •  Monitoring Platelet Function
  •  Bedside Coagulation and Platelet Function Testing
  •  Summary
  • References
  • Section IV Anesthesia for Cardiac Surgical Procedures
  • 20 Anesthesia for Myocardial Revascularization
  •  Epidemiology
  •  Pathophysiology of Coronary Artery Disease
  •  Risk Assessment in Patients Scheduled for Coronary Artery Bypass Grafting
  •  Anesthesia for Coronary Artery Bypass Grafting
  •  Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass
  •  Minimally Invasive Coronary Artery Surgery
  •  Conclusions
  • References
  • 21 Valvular Heart Disease
  •  Pathophysiology
  •  Aortic Stenosis
  •  Hypertrophic Cardiomyopathy
  •  Aortic Regurgitation
  •  Mitral Regurgitation
  •  Mitral Stenosis
  •  Tricuspid Regurgitation
  •  Innovations in Valve Repair
  •  New Techniques for Mitral Valve Repair
  •  Case Study 1: Transapical Aortic Valve Implantation
  •  Case Study 2: Robotically Assisted Mitral Valve Repair
  •  Case Study 3: Mitral Valve Repair With Systolic Anterior Motion After Bypass Needing Additional Repair
  • References
  • 22 Congenital Heart Disease in Adults
  •  Noncardiac Surgery in Adults With Congenital Heart Disease
  •  General Noncardiac Issues With Longstanding Congenital Heart Disease
  •  Cardiac Issues
  •  Case Study 1: Atrial Septal Defect
  •  Case Study 2: Anomalous Left Main Coronary Artery
  • References
  • 23 Thoracic Aorta
  •  Anatomy of the Aorta
  •  General Considerations for the Perioperative Care of Aortic Surgical Patients
  •  Thoracic Aortic Aneurysm
  •  Aortic Dissection
  •  Penetrating Atherosclerotic Ulcer
  •  Traumatic Aortic Injury
  •  Aortic Atheromatous Disease
  •  Takayasu Arteritis
  •  Aortic Coarctation
  •  Illustrative Transesophageal Echocardiography Cases
  • References
  • 24 Uncommon Cardiac Diseases
  •  Cardiac Tumors
  •  Cardiomyopathy
  •  Mitral Valve Prolapse
  •  Patent Foramen Ovale
  •  Pulmonary Hemorrhage
  •  Pericardial Heart Disease
  •  Combined Carotid and Coronary Artery Disease
  •  Coronary Arteriovenous Fistula
  •  Cardiac Surgery During Pregnancy
  •  Risks of Human Immunodeficiency Virus Transmission
  •  Renal Insufficiency and Cardiac Surgery
  •  Hematologic Problems in Patients Undergoing Cardiac Surgery
  •  Acknowledgments
  • References
  • 25 Anesthesia for Heart, Lung, and Heart-Lung Transplantation
  •  Heart Transplantation
  •  Lung Transplantation
  •  Heart-Lung Transplantation
  • References
  • 26 Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension
  •  Classification of Pulmonary Hypertension
  •  Pathophysiology
  •  Clinical Manifestations
  •  Diagnostic Evaluation
  •  Operation
  •  Anesthetic Management of Patients Undergoing Pulmonary Thromboendarterectomy
  •  Management of the Postoperative Patient
  •  Nonsurgical Approach to Chronic Thromboembolic Disease
  •  Intraoperative Echocardiography in Patients With Chronic Thromboembolic Pulmonary Hypertension
  •  Pulmonary Thromboendarterectomy in Patients With Sickle Cell Disease
  •  Outcome and Future of Chronic Thromboembolic Pulmonary Hypertension
  • References
  • 27 Procedures in the Hybrid Operating Room
  • Procedures
  • Miscellaneous Procedures
  • References
  • 28 Mechanical Assist Devices for Heart Failure
  •  The Current Era of Mechanical Circulatory Support
  •  Mechanical Circulatory Support: Theory and Practice
  •  Short-Term Support
  •  Long-Term Support
  •  Complications of Mechanical Circulatory Support
  •  Total Artificial Hearts
  •  Perioperative Anesthetic Considerations for VAD Support
  •  Potential Effects of LVAD Support on Right Ventricular Function
  •  Anesthetic Considerations for SynCardia Total Artificial Heart Implantation
  •  Conclusion
  • References
  • 29 Reoperative Cardiac Surgery
  •  Reoperative Cardiac Surgery
  •  Emergency Reexploration
  • References
  • 30 Patient Safety in the Cardiac Operating Room
  •  The Science of Safety
  •  Human Error
  •  Teamwork and Communication
  •  Interventions to Improve Patient Safety
  •  Medication Safety
  •  Reducing System Vulnerability
  •  Culture of Safety
  • References
  • Section V Extracorporeal Circulation
  • 31 Cardiopulmonary Bypass Management and Organ Protection
  •  Historical Perspective on Cardiopulmonary Bypass
  •  Goals and Mechanics of Cardiopulmonary Bypass
  •  Physiologic Parameters of Cardiopulmonary Bypass
  •  End-Organ Effects of Cardiopulmonary Bypass
  •  Central Nervous System Injury
  •  Acute Kidney Injury
  •  Myocardial Injury
  •  Gastrointestinal Complications
  •  Lung Injury During Cardiac Surgery
  •  Management of Bypass
  •  Initiation and Discontinuation of Bypass Support: An Overview
  •  Perfusion Emergencies
  •  Special Patient Populations
  •  Minimally Invasive Surgery and Cardiopulmonary Bypass
  • References
  • 32 Extracorporeal Devices and Related Technologies
  •  Mechanical Devices
  •  Electronic Perfusion Records
  •  Extracorporeal Circuitry
  •  Cardioplegia Delivery
  •  The Heart-Lung Machine Priming Solutions
  •  Coated Circuits
  •  Perfusion Practices
  •  Methods of Extracorporeal Circulation
  •  Summary
  • References
  • 33 Extracorporeal Membrane Oxygenation
  •  History, Evolution, and Current Status of ECMO
  •  ECMO Physiology and Gas Exchange
  •  Management of Venoarterial ECMO
  •  Management of Venovenous ECMO
  •  Expanded Indications for Venovenous ECMO
  •  Anticoagulation for ECMO
  •  Complications in ECMO
  •  Summary
  • References
  • 34 Blood and Fluid Management During Cardiac Surgery
  •  Transfusion Guidelines
  •  Blood Groups and Transfusion
  •  Genetic Causes of Hemorrhage
  •  Bleeding After Cardiac Surgery
  •  Replacement Therapy
  •  Lowest Hematocrit on Cardiopulmonary Bypass
  •  Conclusions
  • References
  • 35 Transfusion Medicine and Coagulation Disorders
  •  Overview of Hemostasis
  •  Heparin
  •  Alternative Modes of Anticoagulation
  •  Protamine
  •  Bleeding Patient
  • References
  • 36 Discontinuing Cardiopulmonary Bypass
  •  General Preparations
  •  Preparing the Lungs
  •  Preparing the Heart
  •  Final Considerations and Preparations
  •  Routine Weaning From Cardiopulmonary Bypass
  •  Pharmacologic Management of Ventricular Dysfunction
  •  Intraaortic Balloon Pump Counterpulsation
  • References
  • Section VI Postoperative Care
  • 37 Fast-Track Postoperative Cardiac Recovery and Outcomes
  •  Fast-Track Cardiac Surgical Care
  •  Initial Management of Patients in Fast-Track Cardiac Anesthesia: The First 24 Hours
  •  Management of Postoperative Complications
  • References
  • 38 Postoperative Cardiovascular Management
  •  Oxygen Transport
  •  Temperature
  •  Assessment of the Circulation
  •  Postoperative Myocardial Dysfunction
  •  Postoperative Myocardial Ischemia
  •  Therapeutic Interventions
  •  Postoperative Hypertension
  •  Postoperative Vasodilation
  •  Coronary Artery Spasm
  •  Decreased Contractility
  •  Right-Sided Heart Failure
  •  Cardiac Tamponade
  •  Transplanted Heart
  •  Advances in Cardiovascular Surgery and Postoperative Management
  • References
  • 39 Postoperative Respiratory Care
  •  Risk Factors for Respiratory Insufficiency
  •  Additional Therapy in Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome
  •  Impediments to Weaning and Extubation
  •  Modes of Ventilator Support
  •  Liberation From Mechanical Support (Weaning)
  •  Conclusions
  • References
  • 40 Central Nervous System Dysfunction After Cardiopulmonary Bypass
  •  Categorization of Central Nervous System Injury
  •  Neuropsychologic Dysfunction
  •  Mechanisms of Brain Injury
  •  Cerebral Blood Flow
  •  Cardiopulmonary Bypass Equipment
  •  Cerebroprotective Strategies
  •  Procedural Risk
  •  Minimal Access Surgery and Circulatory Support
  • References
  • 41 Long-Term Complications and Management
  •  Infections After Cardiac Surgery
  •  Acute Kidney Injury
  •  Nutritional Support
  •  Complications of Transcatheter Aortic Valve Replacement
  •  Complications of Minimally Invasive Cardiac Surgery
  •  Complications of Mechanical Assist Devices
  •  Patient and Family Support, Palliative Care, and End-of-Life Issues
  • References
  • 42 Postoperative Pain Management for the Cardiac Patient
  •  Pain and Cardiac Surgery
  •  Potential Clinical Benefits of Adequate Postoperative Analgesia
  •  Techniques Available for Postoperative Analgesia
  •  Local Anesthetic Infiltration
  •  Nerve Blocks
  •  Opioids
  •  Patient-Controlled Analgesia
  •  Nonsteroidal Antiinflammatory Agents
  •  Alpha2-Adrenergic Agonists
  •  Intrathecal and Epidural Techniques
  •  Multimodal Analgesia
  •  How Important Is Postoperative Pain After Cardiac Surgery?
  •  Conclusions
  • References
  • Section VII The Cardiac Patient for Noncardiac Surgery
  • 43 Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery
  •  Preoperative Cardiac Assessment: Categorizing Risk
  •  Preoperative Cardiac Assessment: Risk Model Calculators
  •  Perioperative Cardiac Assessment: Algorithmic Approach
  •  Management of Perioperative Anemia
  •  Pulmonary Vascular Disease and Right Ventricular Dysfunction
  •  Summary
  • References
  • 44 The Patient With Coronary Stents Undergoing Noncardiac Surgery
  •  Optimal Stenting Technique
  •  Types of Stents
  •  Vascular and Biologic Response to Stent Placement
  •  Antiplatelet Therapy
  •  Long-Term Antiplatelet Management
  •  Noncardiac Surgery and Coronary Stents
  •  An Integrated Approach
  • References
  • 45 Ventricular Assist Devices, Cardiac Transplants, and Implanted Electrical Devices in Noncardiac Surgery
  •  Ventricular Assist Devices
  •  Anesthesia for Noncardiac Surgery After Heart Transplantation
  •  Cardiovascular Implantable Electronic Device Management in Noncardiac Surgery
  • References
  • 46 Echocardiography in Noncardiac Surgery
  •  Rescue Echocardiography
  •  Transesophageal Echocardiography as a Monitor in Noncardiac Surgical Procedures
  •  Transthoracic Echocardiography
  •  Conclusion
  • References
  • 47 Goal-Directed Fluid Therapy, Enhanced Recovery, and the Perioperative Surgical Home for Cardiac Patients in Noncardiac Surgery
  •  Goal-Directed Fluid Therapy
  •  Enhanced Recovery
  •  Perioperative Surgical Home
  • References
  • 48 Vascular Surgery
  •  General Considerations in Perioperative Management for Vascular Surgery
  •  Carotid Artery and Cerebrovascular Disease
  •  Abdominal Aortic Disease
  •  Lower Extremity Arterial Disease
  • References
  • 49 The Cardiac Patient for Thoracic Noncardiac Surgery
  •  Anesthetic Management for Pulmonary Resection in the Patient With Cardiac Disease
  •  Lung Isolation for Cardiac Patients Having Thoracic Procedures
  •  Management of One-Lung Ventilation
  •  Transesophageal Echocardiography for Noncardiac Thoracic Surgery
  •  Airway Surgery
  •  Pulmonary Hemorrhage
  •  Mediastinal Masses
  •  Vascular Anomalies With Airway Compression
  • References
  • 50 The Pregnant Patient With Cardiac Disease
  •  Diagnosis of Heart Disease During Pregnancy
  •  Cardiac Risk Stratification During Pregnancy
  •  Pregnancy and Cardiac Disease
  •  Management of Labor and Delivery in Women With Cardiac Disease
  •  Noncardiac Surgical Procedures During Pregnancy in Women With Cardiac Disease
  •  Peripartum Cardiomyopathy
  •  Advanced Cardiac Life Support in the Pregnant Woman
  • References
  • 51 Critical Care Medicine in the Operating Room
  •  Perioperative Triage
  •  Neurologic System
  •  Cardiovascular System
  •  Pulmonary System
  •  Hematology
  •  Sepsis
  • References
  • 52 Perioperative Care to Reduce Major Adverse Cardiac Events and Mortality in Noncardiac Surgical Procedures
  •  Perioperative Myocardial Infarction or Injury
  •  Medications and Percutaneous Interventions to Prevent and Treat Perioperative Major Adverse Cardiac Events
  •  Treatment of Perioperative Myocardial Infarction
  •  Perioperative Care to Reduce Mortality Rates in Noncardiac Surgical Procedures
  • References
  • Index

Product details

  • No. of pages: 1688
  • Language: English
  • Copyright: © Elsevier 2016
  • Published: May 5, 2016
  • Imprint: Elsevier
  • eBook ISBN: 9780323463010
  • Hardcover ISBN: 9780323393782

About the Author

Joel Kaplan

Affiliations and Expertise

Dean, School of Medicine; Vice President for Health Affairs; Professor, Department of Anesthesiology, University of Louisville, Louisville, KY

Ratings and Reviews

Write a review

There are currently no reviews for "Kaplan's Cardiac Anesthesia"