Index Note: Page numbers of article titles are in boldface type. A Ablation, radiofrequency, anesthetic considerations for, 479 489 Acute aortic syndrome, thoracic endovascular repair of, 457 462 aortic dissection, 458 461 intramural hematoma, 461 penetrating atherosclerotic aortic ulcer, 461 462 Acute kidney injury, as complication of transcatheter aortic valve replacement, 373 373 associated with cardiac surgery, role of crystalloids in, 276 Adults, Fontan conversion surgery in, 405 419 ADVANCE Trial, of HeartWare ventricular assist device, 346 Analysis, generating new knowledge in cardiac interventions, 217 248 Anemia, preoperative pharmacologic optimization of, 434 438 erythropoietin-stimulating agents, 436 438 intravenous iron supplementation, 434 436 Aneurysm, aortic. See Aortic aneurysm. Aortic aneurysm, thoracic endovascular aortic repair of, 455 456 aortic arch aneurysm, 464 descending thoracic, 455 456 ruptured descending thoracic, 456 thoracoabdominal, 462 463 Aortic dissection, thoracic endovascular aortic repair of, 458 459 Aortic valve replacement, transcatheter, 355 381 avoiding complications, 369 374 equipment, 355 358 indications and contraindications, 358 360 patient preparation, 360 361 postprocedure care, 368 369 technique, best practices, and procedure steps, 362 368 Arrhythmia, in adults undergoing Fontan conversion surgery, 413 Atrial fibrillation, postoperative, preventive role of crystalloid solutions, 277 278 Axial flow, physiology of, 326 327 B Balanced general anesthesia, for transcatheter aortic valve replacement, 366 369 Basic science. See Research. Bleeding risk, in adults undergoing Fontan conversion surgery, 415 Blood management, 433 450 components of program, 433 434 data collection and education, 447 preoperative evaluation, 434 preoperative pharmacologic optimization of anemia, 434 438 Anesthesiology Clin 31 (2013) 491 503 http://dx.doi.org/10.1016/s1932-2275(13)00024-4 anesthesiology.theclinics.com 1932-2275/13/$ see front matter ª 2013 Elsevier Inc. All rights reserved.
492 Index Blood (continued) erythropoietin-stimulating agents, 436 438 intravenous iron supplementation, 434 436 thromboelastography, 438 447 algorithms, 442 445 cell salvage, 446 447 outcomes, 446 ROTEM, 438 442 C Cardiac anesthesia, 207 489 blood management, 433 450 components of program, 433 434 data collection and education, 447 preoperative evaluation, 434 preoperative pharmacologic optimization of anemia, 434 438 thromboelastography, 438 447 cardiac transplantation, 383 403 current status of, 385 386 donor evaluation and selection, 389 donor harvest and preservation, 389 392 history of, 383 385 induction and maintenance of general anesthesia, 393 394 left ventricular assist devices, 387 388 preanesthetic considerations, 392 393 recipient selection, 388 389 retransplantation, 386 387 right heart failure after, 397 399 causes, 397 inotropic agents, 398 399 manifestations, 398 mechanical circulatory support, 399 pacing, 399 patients at risk, 398 therapy, 398 techniques, 395 397 heterotopic, 395 396 orthotopic, 395 weaning from cardiopulmonary bypass, 396 397 critical care of cardiac patients, 421 432 challenges and strategies for new procedures, 426 428 evolving strategies in, 422 426 central line management, 424 425 hemodynamic monitoring, 425 426 mechanical ventilation, 422 423 transfusion, 423 424 fluid management in, 269 280 clinical practice, 272 colloids, 272 273 crystalloids, 273 278
theoretical framework, 270 272 for adults undergoing Fontan conversion surgery, 405 419 evolution and outcomes of, 407 410 perioperative considerations, 410 417 for electrophysiologic procedures, 479 489 anesthesia consultations, 483 avoiding complications, 486 487 contraindications, 483 environment and equipment, 480 481 indications, 481 483 patient preparation, 483 postprocedural care, 485 486 radiation safety, 487 techniques and best practice, 483 485 future of, 207 216 changes and opportunities in US health care, 212 214 fellowships, training, and certification, 211 212 translation of basic science research, 207 211 perioperative genomics, 209 211 preconditioning and intermittent reperfusion, 208 209 stem cell therapy, 209 generating new knowledge in cardiac interventions, 217 248 clinical research, 227 237 technique for successful, 237 243 driving forces, 219 227 team involved in, 217 219 ischemic mitral regurgitation, 281 298 definition and presentation, 281 282 intraoperative echocardiography examination, 285 288 mechanisms, 282 285 percutaneous options, 294 surgical indications and considerations, 288 290 surgical interventional options, 290 294 surgical outcomes, 294 mechanical circulatory support, 321 353 second-generation ventricular assist devices, 322 343 anesthetic management, 332 335 complications, 340 341 contraindications, 324 HeartMate II, 327 331 indications, 322 324 risk assessment, 324 327 role of transesophageal echocardiography, 335 340 surgical considerations, 331 332 troubleshooting, 341 343 third-generation ventricular assist devices, 343 347 HeartWare VAD, 343 347 quality, patient safety, and surgical team, 249 268 background, 249 250 history of improving outcomes, 256 264 collaboratives, 257 260 Index 493
494 Index Cardiac (continued) process redesign, 260 262 registries, 257 report cards and public reporting, 257 teamwork, communication, and culture change, 262 264 improving, 253 256 evolution of QI methods in, 253 254 safety in, 254 256 introduction to quality and safety, 250 253 perceptions of, 250 251 reasons for poor, 251 252 types of errors, 252 253 robotic-assisted minimally invasive mitral valve surgery, 299 320 anesthesia for, 303 305 cardiopulmonary bypass management, 313 immediate postbypas management, 314 mitral valve exposure and repair, 314 postoperative pain management, 315 preparing for transfer and the ICU, 315 previous cardiac surgery and, 312 313 vascular cannulation for, 305 312 thoracic endovascular aortic repair, 451 478 anesthetic management, 464 474 available devices, 452 indications and potential uses for, 455 464 preoperative imaging and evaluation, 452 surgical considerations for specific hybrid procedures, 452 455 transcatheter aortic valve replacement, 355 381 avoiding complications, 369 374 equipment, 355 358 indications and contraindications, 358 360 patient preparation, 360 361 postprocedure care, 368 369 technique, best practices, and procedure steps, 362 368 Cardiac interventions, generating new knowledge in, 217 248 clinical research, 227 237 technique for successful, 237 243 driving forces, 219 227 team involved in, 217 219 Cardiac transplantation. See Transplantation, cardiac. Cardioplegia, in minimally invasive mitral valve surgery, 311 312 solutions and, in cardiac surgery, 276 Cardiopulmonary bypass, management in minimally invasive mitral valve surgery, 313 separation from and immediate post-bypass management, 314 weaning from, after cardiac transplantation, 396 397 Cardioversion, anesthetic considerations for, 479 489 Cardioverter-defibrillator, anesthetic considerations for implantation, 479 489 Catheter ablation, anesthetic considerations for, 479 489 Central line management, in critical care of cardiac patients, 424 425 Certification, in future of cardiothoracic anesthesia, 211 212 Chloride concentration, effect on inflammation, infection, and immunity, 277
Index 495 Circulatory support, mechanical. See Ventricular assist devices. Clinical research, generating new knowledge in cardiac interventions, 217 248 driving forces, 219 227 team involved in, 217 219 technique for successful, 237 243 Coagulation, in adults undergoing Fontan conversion surgery, 415 Collaboratives, in cardiac surgery, improving quality and patient safety with, 258 260 Colloids, in cardiac surgery, 272 273 versus crystalloids, 271 272 Communication, in cardiac surgery, improving quality and patient safety with, 262 264 Conduction abnormalities, as complication of transcatheter aortic valve replacement, 374 Congenital heart disease, in adults, Fontan conversion surgery in, 405 419 Continuous quality improvement. See Quality improvement. Critical care, of cardiac patients, 421 432 challenges and strategies for new procedures, 426 428 evolving strategies in, 422 426 central line management, 424 425 hemodynamic monitoring, 425 426 mechanical ventilation, 422 423 transfusion, 423 424 Crystalloids, in cardiac surgery, 273 278 cardioplegia solutions, 276 hypertonic solutions, 274 276 importance of physiologically balanced solutions, 273 274 in acute kidney injury associated with, 276 inflammation, infection, immunity, and high chloride concentrations, 277 prevention of postoperative atrial fibrillation, 277 278 versus colloids, 271 272 Culture change, in cardiac surgery, improving quality and patient safety with, 262 264 D Data, generating new knowledge in cardiac interventions, 217 248 Descending thoracic aortic aneurysm, thoracic endovascular aortic repair of, 455 456 Dissection, aortic, thoracic endovascular aortic repair of, 458 459 Donors, for cardiac transplantation, 390 392 evaluation and selection, 390 heart harvest and preservation, 390 392 E Echocardiography, intraoperative transesophageal, during placement of ventricular assist devices, 335 340 in patients with ischemic mitral regurgitation, 285 288 in robotic-assisted minimally invasive mitral valve surgery, 304 305 transesophageal, in adults undergoing Fontan conversion surgery, 410 412 Electrophysiologic procedures, anesthetic considerations for, 479 489 anesthesia consultations, 483 avoiding complications, 486 487 contraindications, 483 environment and equipment, 480 481 drugs frequently used in, 481
496 Index Electrophysiologic (continued ) monitors, 481 remote location, 480 room setup, 480 481 indications, 481 483 patient preparation, 483 postprocedural care, 485 486 radiation safety, 487 techniques and best practice, 483 485 commonly used medications, 484 sedation vs. general anesthesia, 483 484 specific considerations, 484 485 Endovascular techniques. See Thoracic endovascular aortic repair. Endurance Trial, of HeartWare ventricular assist device, 347 Errors, medical, types of, and how they jeopardize safety, 252 253 Erythropoietin-stimulating agents, for preoperative optimization of anemia, 436 438 External cardioversion, anesthetic considerations for, 479 489 Extubation, early, in adults undergoing Fontan conversion surgery, 417 F Fellowships, in future of cardiothoracic anesthesia, 211 212 Fluid management, in cardiac surgery, 269 280 clinical practice, 272 colloids, 272 273 crystalloids, 273 278 cardioplegia solutions, 276 hypertonic solutions, 274 276 importance of physiologically balanced solutions, 273 274 in acute kidney injury associated with, 276 inflammation, infection, immunity, and high chloride concentrations, 277 prevention of postoperative atrial fibrillation, 277 278 theoretical framework, 270 272 body fluid composition, physiology, and surgery, 270 271 physiology of fluid disposition, 271 272 Fontan conversion surgery, in adults, 405 419 evolution and outcomes of, 407 410 history, 407 408 lateral tunnel vs. extracardiac, 409 Texas Children s Hospital data, 409 410 perioperative considerations, 410 417 anesthetic considerations, 412 417 risk stratification, 410 transesophageal echocardiography before and after, 410 412 Future, of cardiac anesthesia, 207 216 changes and opportunities in US health care, 212 214 fellowships, training, and certification, 211 212 translation of basic science research, 207 211 perioperative genomics, 209 211 preconditioning and intermittent reperfusion, 208 209 stem cell therapy, 209
Index 497 G General anesthesia, balanced, for transcatheter aortic valve replacement, 366 369 Genomics, perioperative, translation of basic science research, 209 211 H Heart disease, congenital. See Congenital heart disease. Heart transplantation. See Transplantation, cardiac. HeartMate II ventricular assist device, 327 331 HeartWare ventricular assist device, 343 347 Hematoma, intramural, thoracic endovascular aortic repair of, 461 Hemodynamic monitoring, in critical care of cardiac patients, 425 426 Heterotopic heart transplantation, 395 Hypertonic solutions, in cardiac surgery, 274 276 I Imaging, transesophageal echocardiography, in adults undergoing Fontan conversion surgery, 410 412 intraoperative, in patients with ischemic mitral regurgitation, 285 288 in robotic-assisted minimally invasive mitral valve surgery, 304 305 Immunity, effect of high chloride concentration on, 277 Implantable cardioverter-defibrillator, anesthetic considerations for implantation, 479 489 Infection, effect of high chloride concentration on, 277 Inflammation, effect of high chloride concentration on, 277 Inotropic agents, to prevent right heart failure after cardiac transplantation, 398 399 INTERMACS Registry, 324 325 Intermittent reperfusion, translation of basic science research, 208 209 Interventions, cardiac, generating new knowledge in, 217 248 clinical research, 227 237 technique for successful, 237 243 driving forces, 219 227 team involved in, 217 219 Intramural hematoma, thoracic endovascular aortic repair of, 461 Intraoperative transesophageal echocardiography, in patients with ischemic mitral regurgitation, 285 288 in robotic-assisted minimally invasive mitral valve surgery, 304 305 Iron supplementation, intravenous, for preoperative optimization of anemia, 434 436 Ischemic mitral regurgitation, 281 298 definition and presentation, 281 282 intraoperative echocardiography examination, 285 288 mechanisms, 282 285 percutaneous options, 294 surgical indications and considerations, 288 290 surgical interventional options, 290 294 surgical outcomes, 294 K Kidney injury, acute, as complication of transcatheter aortic valve replacement, 373 374 acute, associated with cardiac surgery, role of crystalloids in, 276
498 Index L Lactic acidosis, in adults undergoing Fontan conversion surgery, 415 417 Left ventricular assist devices, as bridge to cardiac transplantation, 387 388 in critical care of cardiac patients, 426 428 Lietz-Miller risk score, 325 M Matthews risk score, 326 Mechanical circulatory support. See Ventricular assist devices. Mechanical ventilation, in critical care of cardiac patients, 422 423 Minimally invasive mitral valve surgery, robotic-assisted, 299 320 anesthesia for, 303 305 cardiopulmonary bypass management, 313 immediate postbypas management, 314 mitral valve exposure and repair, 314 postoperative pain management, 315 preparing for transfer and the ICU, 315 previous cardiac surgery and, 312 313 vascular cannulation for, 305 312 Mitral valve disease, ischemic mitral regurgitation, 281 298 Mitral valve surgery, robotic-assisted minimally invasive, 299 320 anesthesia for, 303 305 airway management, 304 intraoperative transesophageal echocardiography, 304 305 preoperative preparation, 303 type of, and patient positioning, 303 304 cardiopulmonary bypass management, 313 immediate postbypas management, 314 mitral valve exposure and repair, 314 postoperative pain management, 315 preparing for transfer and the ICU, 315 previous cardiac surgery and, 312 313 vascular cannulation for, 305 312 arterial outflow and cross-clamping, 307 311 cardioplegia, 311 312 venous drainage, 305 307 O Orthotopic heart transplantation, 395 P Pacemaker implantation, permanent, anesthetic considerations for, 479 489 Pain management, postoperative, in minimally invasive mitral valve surgery, 315 Patient safety. See Safety, patient. Penetrating atherosclerotic aortic ulcer, thoracic endovascular aortic repair of, 461 462 Percutaneous approaches, to treatment of ischemic mitral regurgitation, 294 Peripheral vascular injury, as complication of transcatheter aortic valve replacement, 370 Preconditioning, translation of basic science research, 208 209
Index 499 Process redesign, in cardiac surgery, improving quality and patient safety with, 260 262 Protein-losing enteropathy, in adults undergoing Fontan conversion surgery, 414 415 Public reporting, improving quality and patient safety with, 257 Q Quality improvement (QI), and patient safety and the cardiac surgical team, 249 268 background, 249 250 history of improving outcomes, 256 264 collaboratives, 257 260 process redesign, 260 262 registries, 257 report cards and public reporting, 257 teamwork, communication, and culture change, 262 264 improving, 253 256 evolution of QI methods in, 253 254 safety in, 254 256 introduction to safety and, 250 253 perceptions of, 250 251 reasons for poor, 251 252 types of errors, 252 253 R Radiation safety, for anesthesiologists during electrophysiologic procedures, 487 Radiofrequency ablation, anesthetic considerations for, 479 489 Registries, improving quality and patient safety with, 257 Reperfusion, intermittent, translation of basic science research, 208 209 Report cards, improving quality and patient safety with, 257 Research, generating new knowledge in cardiac interventions, 217 248 clinical research, 227 237 technique for successful, 237 243 driving forces, 219 227 team involved in, 217 219 in cardiothoracic anesthesia, translation of basic science, 207 211 perioperative genomics, 209 211 preconditioning and intermittent reperfusion, 208 209 stem cell therapy, 209 Resynchronization therapy, anesthetic considerations for, 479 489 Retransplantation, cardiac, 386 387 Right heart failure, after cardiac transplantation, 397 399 causes, 397 inotropic agents, 398 399 manifestations, 398 mechanical circulatory support, 399 pacing, 399 patients at risk, 398 therapy, 398 Robotic-assisted mitral valve surgery, 299 320 anesthesia for, 303 305 cardiopulmonary bypass management, 313
500 Index Robotic-assisted (continued ) immediate postbypas management, 314 mitral valve exposure and repair, 314 postoperative pain management, 315 preparing for transfer and the ICU, 315 previous cardiac surgery and, 312 313 vascular cannulation for, 305 312 ROTEM device, 438 442 S Safety, patient, and quality and the cardiac surgical team, 249 268 background, 249 250 history of improving outcomes, 256 264 collaboratives, 257 260 process redesign, 260 262 registries, 257 report cards and public reporting, 257 teamwork, communication, and culture change, 262 264 improving, 253 256 evolution of QI methods in, 253 254 safety in, 254 256 introduction to quality and, 250 253 perceptions of, 250 251 reasons for poor, 251 252 types of errors, 252 253 Stem cell therapy, translation of basic science research, 209 Stroke, as complication of transcatheter aortic valve replacement, 370 373 Surgical procedures. See also Cardiac anesthesia., cardiac transplantation, 383 403 current status of, 385 386 donor evaluation and selection, 389 donor harvest and preservation, 389 392 history of, 383 385 induction and maintenance of general anesthesia, 393 394 left ventricular assist devices, 387 388 preanesthetic considerations, 392 393 recipient selection, 388 389 retransplantation, 386 387 right heart failure after, 397 399 techniques, 395 397 Fontan conversion in adults, 405 419 evolution and outcomes of, 407 410 history, 407 408 lateral tunnel vs. extracardiac, 409 Texas Children s Hospital data, 409 410 perioperative considerations, 410 417 anesthetic considerations, 412 417 risk stratification, 410 transesophageal echocardiography before and after, 410 412 for ischemic mitral regurgitation, 288 294 indications and considerations, 288 290
Index 501 interventional options, 290 294 outcomes, 294 transcatheter aortic valve replacement, 355 381 avoiding complications, 369 374 equipment, 355 358 indications and contraindications, 358 360 patient preparation, 360 361 postprocedure care, 368 369 technique, best practices, and procedure steps, 362 368 T Teamwork, in cardiac surgery, improving quality and patient safety with, 262 264 Thoracic aortic injury, blunt traumatic, endovascular repair of, 456 457 Thoracic endovascular aortic repair, 451 478 anesthetic management, 464 474 postoperative management, 472 474 preanesthetic evaluation and preparation, 464 465 specialized perioperative monitoring, 469 472 specific considerations, 465 469 technique, 469 available devices, 452 indications and potential uses for, 455 464 acute aortic syndrome, 457 462 aortic arch aneurysm, 463 blunt traumatic thoracic aortic injury, 456 457 descending thoracic aortic aneurysm, 455 456 ruptured descending thoracic aortic aneurysm, 456 thoracoabdominal aortic aneurysm, 462 463 preoperative imaging and evaluation, 452 surgical considerations for specific hybrid procedures, 452 455 aortic visceral debranching procedure, 454 455 frozen elephant-trunk technique, 454 hybrid elephant-trunk procedure, 454 left subclavian artery coverage and revascularization, 453 454 Thoracoabdominal aortic aneurysm, endovascular aortic repair of, 462 463 Thromboelastography, 438 447 algorithms, 442 445 cell salvage, 446 447 outcomes, 446 ROTEM, 438 442 Training, in future of cardiothoracic anesthesia, 211 212 Transcatheter aortic valve replacement, 355 381 avoiding complications, 369 374 equipment, 355 358 indications and contraindications, 358 360 patient preparation, 360 361 postprocedure care, 368 369 technique, best practices, and procedure steps, 362 368 anesthetic concerns for, 365 368 other approaches, 365
502 Index Transcatheter (continued ) transapical approach, 364 365 transfemoral approach, 362 364 Transesophageal echocardiography, in adults undergoing Fontan conversion surgery, 410 412 intraoperative, during placement of ventricular assist devices, 335 340 in patients with ischemic mitral regurgitation, 285 288 in robotic-assisted minimally invasive mitral valve surgery, 304 305 Transfusion, in critical care of cardiac patients, 423 424 Transplantation, cardiac, 383 403 current status of, 385 386 donor evaluation and selection, 389 donor harvest and preservation, 389 392 history of, 383 385 induction and maintenance of general anesthesia, 393 394 left ventricular assist devices, 387 388 preanesthetic considerations, 392 393 recipient selection, 388 389 retransplantation, 386 387 right heart failure after, 397 399 causes, 397 inotropic agents, 398 399 manifestations, 398 mechanical circulatory support, 399 pacing, 399 patients at risk, 398 therapy, 398 techniques, 395 397 heterotopic, 395 396 orthotopic, 395 weaning from cardiopulmonary bypass, 396 397 ventricular assist devices as bridge to, 322 323 Trauma, blunt thoracic aortic injury, endovascular repair of, 456 457 U Ulcer, penetrating atherosclerotic aortic ulcer, endovascular aortic repair of, 461 462 V Venous capacitance, in adults undergoing Fontan conversion surgery, 412 417 Venous drainage, in robotic-assisted minimally invasive mitral valve surgery, 305 307 Ventricular assist devices, 321 353 as bridge to cardiac transplantation, 387 388 in critical care of cardiac patients, 426 428 second-generation, 322 343 anesthetic management, 332 335 complications, 340 341 contraindications, 324 HeartMate II, 327 331 indications, 322 324
risk assessment, 324 327 role of transesophageal echocardiography, 335 340 surgical considerations, 331 332 troubleshooting, 341 343 third-generation, 343 347 HeartWare VAD, 343 347 Ventricular remodeling, ischemic mitral regurgitation due to, 282 285 Index 503