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Chapter 37 - Cardiopulmonary Bypass (CPB) and Associated Anticoagulation

from Section 2 - Cardiac, Thoracic, and Vascular Anesthesia

Published online by Cambridge University Press:  03 August 2023

Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 69-year-old female is scheduled to undergo a coronary revascularization, as well as an aortic valve replacement for severe aortic stenosis. Her past medical history is significant for a non-ST segment myocardial infarction (MI), hypertension, progressive aortic stenosis with mildly depressed left ventricular function, and diabetes mellitus. Her past surgical history is significant for endoscopic sinus surgery 3 years prior and a left femoral-distal bypass graft 2 years ago. She does not report any adverse anesthetic complications but does report a fall in her platelet count when she was hospitalized for lower extremity ischemia. What are your concerns? What pre-operative workup would you like? How does her medical history affect your intra-operative plans?

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