Cardiac and Thoracic Anesthesiology

Abstract

An understanding of cardiac and thoracic anatomy and physiology is critical to the care of patients with cardiac or thoracic pathology undergoing surgery and anesthesia. This chapter will review common pathophysiology and anesthetic management strategies for patients with myocardial ischemia, valvular disease, and heart failure. Many cardiac surgeries require the use of cardiopulmonary bypass, and the basics of this equipment and intraoperative anesthetic management of patients on bypass are also discussed. A review of thoracic anatomy and an understanding of the anesthetic implications of mediastinal or pulmonary disease is important for patients requiring thoracic surgery for lung cancer or mediastinal masses. A unique consideration for these patients is the use of one-lung ventilation to allow for surgery in the thorax, and the use of double-lumen endotracheal tubes and endobronchial blockers for this purpose is also reviewed.