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Contents:
The American Society of Anesthesiology site includes general Practice Guidelines for the basics of preoperative evaluation and preoperative care (as well as Standards for intraoperative monitoring and postoperative care) of cardiac patients. Many patients presenting for thoracic and vascular surgery have concomitant cardiac disease. The American College of Cardiology / American Heart Association Task Force on Practice Guidelines has developed "Guidelines for Perioperative Cardiovascular Evaluation for Non-cardiac Surgery". The ACC site is fantastic, providing downloadable monographs on a huge range of topics, including chronic stable angina, evaluation and management of heart failure, exercise testing etc. A review of adult patients with congenital heart disease is available from the excellent Adult Congenital Heart Association site. The BJA has a great 2002 v88 no5 editorial on pacemakers and ICDs in the anaesthesia setting. Here is Marc Rozner's GasNet discussions about pacemakers. SBE prophylaxis may be important for some patients. See also the American Heart Association Bacterial Endocarditis Guidelines. Resuscitation The Australian Resuscitation Council provide resuscitation guidelines and fowcharts. Basic monitoring concerns are reviewed on this ASA's Practice Guideline site. Further discussion of basic monitoring is provided by this Walter Reed Army Medical anesthesia reference site. Pulmonary Artery Catheter guidelines and blood usage guidelines are on the ASA site also. Echocardiography is well represented on the Web, including these sites:
Other echo sites include : Return to CONTENTS Anaesthetic / Drug Information The cardiovascular and respiratory sections at PharmInfoNet provide lengthy compilations of the multitude of drugs we're expected to be familiar with. In addition, summaries of peer-reviewed cardiovascular literature may be found, grouped into such topics as CHF and heparin-induced thrombocytopenia. Return to CONTENTS The Heart Surgery Forum presents a number of resources related to cardiac surgery, with extensive discussion of minimally invasive techniques and off-pump CABG. The ACC site should be visited for a review of their Clinical Guidelines. A recent addition is the 2004 Guideline for Coronary Artery Bypass Grafting. and a comparison between GAGs and stenting. The Society of Thoracic Surgeons has this primer for patients needing CABG. Return to CONTENTS The Heart Surgery Forum also addresses issues concerning patients undergoing valve surgery, with emphasis on minimally invasive techniques. ACC/AHA Guidelines for Management of Patients with Valvular Disease The Society of Thoracic Surgeons has this primer for patients needing Aortic Valve surgery, Mitral Valve Replacement or repair. Return to CONTENTS The Dept. of Anesthesia and Critical Care of the Univ. of Chicago maintains the Vascular-thoracic anesthesia manual, which includes resources related to thoracic vascular, other vascular and pulmonary surgery, including
The Society of Thoracic Surgeons homepage provides Society info as well as full text cardiovascular and thoracic journal articles. The Cardiothoracic Surgery Network is a great site. The American College of Chest Physicians (ACCP) The Journal Chest provides abstracts and PDF's.. Return to CONTENTS The Internet Journal of Perfusionists provides us with some useful articles. Additional sites worth checking out:
The FDA site has a brief overview of VAD devices, as does the American Heart Association, the Cleveland Clinic and Wikipedia. Return to CONTENTS Postoperative bleeding is an unwanted complication, and may be related to platelet dysfunction as discussed by Philip Cumpston. The use of thromboelastography is addressed in the Internet Journal of Anesthesia. Postoperative management of the thoracic patient is reviewed at the vascular-thoracic manual of the University of Chicago, Department of Anesthesia and Critical Care. Postoperative Pain Management is the subject of a separate Virtual Anaesthesia Textbook chapter. Return to CONTENTS
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