Key Points 1. It is easiest to think of coagulation as a wave of biologic activity occurring at the site of tissue injury, consisting of initiation, acceleration, control, and lysis. 2. Hemostasis is part of a larger body system: inflammation.…
Key Points 1. Two predominant methods of blood propulsion are used: positive displacement roller pumps and constrained vortex centrifugal-type pumps. 2. Modern heart-lung machines are equipped with a number of alarm systems and redundant backup systems to overcome primary system…
Key Points 1. Cardiopulmonary bypass (CPB) is associated with a number of profound physiologic perturbations. The central nervous system, kidneys, gut, and heart are especially vulnerable to ischemic events associated with extracorporeal circulation. 2. Advanced age is the most important…
Key Points 1. Cardiac surgical patients are at significant risk from preventable adverse events. These events occur through human error, by either faulty decision making (diagnosis, decision for treatment) or faulty actions (failure to implement the plan correctly). 2. Human…
Key Points 1. Reoperative cardiac surgery presents greater risk than first-time surgery because patients are usually older, have more comorbidity, and have more advanced cardiovascular disease. Also, resternotomy can be hazardous due to adhesions of cardiac structures to the sternum.…
Key Points 1. Mechanical circulatory support (MCS) for the failing heart has become a mainstay of the modern management of patients with both acute and chronic heart failure refractory to pharmacologic and other usual interventions. 2. Outcomes with MCS have…
Key Points 1. A hybrid operating room combines advanced imaging capabilities with a fully functioning operating suite. 2. Transcatheter aortic valve replacement (TAVR) is recommended for patients with severe symptomatic aortic stenosis who are inoperable or at high risk for…
Key Points 1. The incidence of thromboembolic disease is difficult to estimate because of the nonspecific nature of presenting symptoms and a lack of awareness of the disorder. 2. Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of a…
Key Points 1. Cardiac denervation is an unavoidable consequence of heart transplantation, and reinnervation is at best partial and incomplete. 2. Drugs acting directly on the heart are the drugs of choice for altering cardiac physiology after heart transplantation. 3.…
Key Points 1. Cardiac tumors are rare. In general, a cardiac mass is more likely a vegetation or a thrombus than a tumor. Secondary (metastatic) tumors are far more common than primary cardiac tumors. Among primary cardiac tumors, benign lesions…