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Cardiac anaesthesia in the elderly 

Cardiac anaesthesia in the elderly
Chapter:
Cardiac anaesthesia in the elderly
Author(s):

Ivan L. Rapchuk

, Pragnesh Joshi

, and John F. Fraser

DOI:
10.1093/med/9780199604999.003.0021
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date: 18 August 2019

This chapter reviews in detail current practices in cardiac anaesthesia with regard to the elderly. After summarizing the important cardiovascular pathophysiological changes with ageing, it describes the major surgical areas of practice, including treatment for ischaemic heart disease, aortic aneurysms, and aortic and mitral valvular disease. Preoperative preparation is discussed as well as the complications of coronary bypass in the elderly. Intraoperative and postoperative care, including cardiorespiratory critical care, the management of bleeding, renal function, neurological dysfunction, and pain control are detailed. The increasing use of mechanical assist devices, largely used for palliative care, is discussed. The current understanding of the complex issue of postcardiac surgical neurological dysfunction is then discussed. Emerging procedures are reviewed including minimally invasive and transcatheter valvular techniques. The role of the anaesthetist in the planning and provision of care for these procedures is reviewed, with emphasis on the need for haemodynamic stability throughout these procedures.

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