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KAPLAN’S CARDIAC ANESTHESIA FOR CARDIAC AND NONCARDIAC SURGERY KAPLAN’S CARDIAC ANESTHESIA FOR CARDIAC AND NONCARDIAC SURGERY S e v e n t h E d i t i o n Editor Joel A. Kaplan, MD, CPE, FACC Professor of Anesthesiology University of California, San Diego La Jolla, California Dean Emeritus School of Medicine Former Chancellor Health Sciences Center University of Louisville Louisville, Kentucky Associate Editors John G.T. Augoustides, MD, FASE, FAHA Professor of Anesthesiology and Critical Care Perelman School of Medicine Hospital of the University of Pennsylvania Philadelphia, Pennsylvania Gerard R. Manecke, Jr., MD Chairman Department of Anesthesiology University of California, San Diego, School of Medicine San Diego, California Timothy Maus, MD, FASE Associate Clinical Professor Director of Perioperative Echocardiography Department of Anesthesiology University of California, San Diego La Jolla, California David L. Reich, MD President and Chief Operating Offcer The Mount Sinai Hospital Horace W. Goldsmith Professor of Anesthesiology Icahn School of Medicine at Mount Sinai New York, New York 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 KAPLAN’S CARDIAC ANESTHESIA: FOR CARDIAC AND NONCARDIAC ISBN: 978-0-323-39378-2 SURGERY: SEVENTH EDITION Copyright © 2017 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the Publisher. Details on how to seek permission, further information about the Publisher’s permissions policies, and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this feld are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods, they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identifed, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence, or otherwise or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2011, 2006, 1999, 1993, 1987, 1979 Library of Congress Cataloging-in-Publication Data Names: Kaplan, Joel A., editor. | Augoustides, John G. T., editor. | Maneck, Gerard R., Jr., editor. | Maus, Timothy, editor. | Reich, David L. (David Louis), 1960– editor. Title: Kaplan’s cardiac anesthesia : for cardiac and noncardiac surgery / editor, Joel A. Kaplan ; associate editors, John G.T. Augoustides, Gerard R. Manecke, Jr., Timothy Maus, David L. Reich. Other titles: Cardiac anesthesia Description: Seventh edition. | Philadelphia, PA : Elsevier, [2017] | Preceded by Kaplan’s cardiac anesthesia : the echo era / editor, Joel A. Kaplan. 6th ed. 2011. | Includes bibliographical references and index. Identifers: LCCN 2016044706 | ISBN 9780323393782 (hardcover : alk. paper) Subjects: | MESH: Anesthesia | Cardiac Surgical Procedures | Heart—drug effects | Perioperative Care Classifcation: LCC RD87.3.C37 | NLM WG 460 | DDC 617.9/6741—dc23 LC record available at https://lccn.loc.gov/2016044706 Executive Content Strategist: Dolores Meloni Senior Content Development Specialist: Ann Ruzycka Anderson Publishing Services Manager: Catherine Albright Jackson Senior Project Manager: Doug Turner Designer: Ryan Cook Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 DEDICATION To my loving wife, Norma, on the occasion of our fftieth wedding anniversary Joel A. Kaplan, MD, CPE, FACC To our families and loved ones for their support and understanding John G.T. Augoustides, MD, FASE, FAHA Gerard R. Manecke, Jr., MD Timothy Maus, MD, FASE David L. Reich, MD v CONTRIBUTORS PHILLIP ADAMS, DO PAUL G. BARASH, MD Department of Anesthesiology Professor University of Pittsburgh Medical Center Department of Anesthesiology Pittsburgh, Pennsylvania Yale University School of Medicine New Haven, Connecticut SHAMSUDDIN AKHTAR, MBBS Associate Professor VICTOR C. BAUM, MD Department of Anesthesiology and Pharmacology US Food and Drug Administration Yale University School of Medicine Silver Spring, Maryland New Haven, Connecticut Departments of Anesthesiology and Critical Care Medicine and Pediatrics SARAH ARMOUR, MD George Washington University Instructor Washington, District of Columbia Anesthesiology Mayo Clinic ANTHONY A. BAVRY, MD, MPH Rochester, Minnesota Associate Professor of Medicine Division of Cardiovascular Medicine WILLIAM R. AUGER, MD University of Florida Professor of Clinical Medicine Director, Interventional Cardiology Division of Pulmonary and Critical Care Medicine North Florida/South Georgia Veterans Health Administration University of California, San Diego Gainesville, Florida La Jolla, California YAAKOV BEILIN, MD JOHN G.T. AUGOUSTIDES, MD, FASE, FAHA Professor Professor of Anesthesiology and Critical Care Departments of Anesthesiology and Obstetrics/Gynecology Perelman School of Medicine Vice Chair for Quality Hospital of the University of Pennsylvania Department of Anesthesiology Philadelphia, Pennsylvania Director of Obstetric Anesthesiology Icahn School of Medicine at Mount Sinai GINA C. BADESCU, MD New York, New York Attending Anesthesiologist Bridgeport Hospital ELLIOTT BENNETT-GUERRERO, MD Stratford, Connecticut Professor and Vice Chair Clinical Research and Innovation JAMES M. BAILEY, MD Department of Anesthesiology Medical Director Stony Brook Medicine Critical Care Stony Brook, New York Northeast Georgia Health System Gainseville, Georgia DAN E. BERKOWITZ, MD Professor DANIEL BAINBRIDGE, MD Anesthesiology and Critical Care Medicine Associate Professor Division of Cardiothoracic Anesthesia Department of Anesthesia and Perioperative Medicine Johns Hopkins University School of Medicine Western University Baltimore, Maryland London, Ontario, Canada MARTIN BIRCH, MD DALIA A. BANKS, MD, FASE Anesthesiologist and Critical Care Physician Clinical Professor of Anesthesiology Hennepin County Medical Center Department of Anesthesiology Minneapolis, Minnesota University of California, San Diego La Jolla, California BRIAN BLASIOLE, MD, PhD Assistant Professor MANISH BANSAL, MD, DNB CARDIOLOGY, FACC, Anesthesiology FASE Children’s Hospital of Pittsburgh of UPMC Senior Consultant Pittsburgh, Pennsylania Department of Cardiology Medanta—The Medicity SIMON C. BODY, MD Gurgaon, Haryana, India Associate Professor of Anesthesia Harvard Medical School Brigham and Women’s Hospital Boston, Massachusetts vi Contributors vii T. ANDREW BOWDLE, MD, PhD BRETT CRONIN, MD Professor of Anesthesiology and Pharmaceutics Assistant Clinical Professor University of Washington Department of Anesthesiology Seattle, Washington University of California, San Diego La Jolla, California CHARLES E. CHAMBERS, MD Professor of Medicine and Radiology DUNCAN G. DE SOUZA, MD, FRCPC Heart and Vascular Institute Clinical Assistant Professor Penn State Hershey Medical Center Department of Anesthesiology Hershey, Pennsylania University of British Columbia Vancouver, British Columbia, Canada MARK A. CHANEY, MD Director Professor and Director of Cardiac Anesthesia Cardiac Anesthesia Anesthesia and Critical Care Kelowna General Hospital The University of Chicago Kelowna, British Columbia, Canada Chicago, Illinois PATRICK A. DEVALERIA, MD ALAN CHENG, MD Consultant Adjunct Associate Professor Cardiac Surgery Johns Hopkins University School of Medicine Mayo Clinic Baltimore, Maryland Phoenix, Arizona DAVY C.H. CHENG, MD, MSC MARCEL E. DURIEUX, MD, PhD Distinguished University Professor and Chair Professor Department of Anesthesia and Perioperative Medicine Departments of Anesthesiology and Neurosurgery Western University University of Virginia London, Ontario, Canada Charlottesville, Virginia ALBERT T. CHEUNG, MD HARVEY L. EDMONDS, JR., PhD Professor Professor Emeritus Department of Anesthesiology Department of Anesthesia and Perioperative Medicine Division Chief University of Louisville Cardiothoracic Anesthesiology Louisville, Kentucky Program Director Adult Cardiothoracic Anesthesiology JOERG KARL ENDER, MD Stanford University School of Medicine Director Stanford, California Department of Anesthesiology Intensive Care Medicine Heart Center JOANNA CHIKWE, MD Leipzig, Germany Professor of Cardiovascular Surgery Department of Cardiovascular Surgery DANIEL T. ENGELMAN, MD Icahn School of Medicine at Mount Sinai Inpatient Medical Director New York, New York Heart and Vascular Center Baystate Medical Center EDMOND COHEN, MD Springfeld, Massachusetts Professor of Anesthesiology and Thoracic Surgery Assistant Professor Icahn School of Medicine at Mount Sinai Department of Surgery New York, New York Tufts University School of Medicine Boston, Massachusetts DAVID J. COOK, MD Emeritus Professor of Anesthesiology LIZA J. ENRIQUEZ, MD Mayo Clinic Anesthesiology Attending Rochester, Minnesota St. Joseph’s Regional Medical Center Chief Clinical and Operating Offcer Paterson, New Jersey Jiahui Health Shanghai, China JARED W. FEINMAN, MD Assistant Professor RYAN C. CRANER, MD Department of Anesthesiology and Critical Care Senior Associate Consultant Hospital of the University of Pennsylvania Anesthesiology Philadelphia, Pennsylvania Mayo Clinic Phoenix, Arizona viii Contributors BYRON FERGERSON, MD VALENTIN FUSTER, MD, PhD, MACC Associate Clinical Professor Physician-in-Chief Associate Director of Resident Education The Mount Sinai Medical Center Department of Anesthesiology Director University of California, San Diego Zena and Michael A. Wiener Cardiovascular Institute and La Jolla, California Marie-Josee and Henry Kravis Center for Cardiovascular Health Staff Physician New York, New York VA San Diego Director Departments of Anesthesiology and Cardiology Centro Nacional de Investigaciones Cardiovasculare (CNIC) San Diego, California Madrid, Spain GREGORY W. FISCHER, MD THERESA A. GELZINIS, MD Professor and Chairman Associate Professor of Anesthesiology Department of Anesthesiology and Critical Care Medicine Department of Anesthesiology Memorial Sloan Kettering Cancer Center University of Pittsburgh New York, New York Pittsburgh, Pennsylvania DAVID FITZGERALD, MPH, CCP KAMROUZ GHADIMI, MD Clinical Coordinator Assistant Professor Division, Cardiovascular Perfusion Cardiothoracic Anesthesiology and Critical Care Medicine College of Health Professions Department of Anesthesiology Medical University of South Carolina Duke University School of Medicine Charleston, South Carolina Durham, North Carolina LEE A. FLEISHER, MD EMILY K. GORDON, MD Robert D. Dripps Professor and Chair Assistant Professor Anesthesiology and Critical Care Department of Anesthesiology and Critical Care Professor Perelman School of Medicine Department of Medicine Hospital of the University of Pennsylvania Perelman School of Medicine Philadelphia, Pennsylvania University of Pennsylvania Philadelphia, Pennsylvania S TEVEN B. GREENBERG, MD Clinical Associate Professor SUZANNE FLIER, MD, MSC Director of Critical Care Services Assistant Professor Evanston Hospital Schulich School of Medicine Department of Anesthesiology University of Western Ontario North Shore University Health System London, Ontario, Canada Evanston, Illinois AMANDA A. FOX, MD, MPH LEANNE GROBAN, MD Vice Chair of Clinical and Translational Research Professor Associate Professor Director, Cardiac Aging Lab Department of Anesthesiology and Pain Management Department of Anesthesiology Associate Professor Wake Forest School of Medicine McDermott Center for Human Growth and Development Winston-Salem, North Carolina University of Texas Southwestern Medical Center Dallas, Texas HIL ARY P. GROCOTT, MD, FRCPC, FASE Professor JONATHAN F. FOX, MD Department of Anesthesia and Perioperative Medicine and Surgery Instructor University of Manitoba Anesthesiology Winnipeg, Manitoba, Canada Mayo Clinic Rochester, Minnesota ROBERT C. GROOM, MS, CCP, FPP Director of Cardiovascular Perfusion JULIE K. FREED, MD, PhD Cardiovascular Services Assistant Professor of Anesthesiology Maine Medical Center Medical College of Wisconsin Portland, Maine Milwaukee, Wisconsin JACOB T. GUTSCHE, MD LEON FREUDZON, MD Assistant Professor Assistant Professor Cardiothoracic and Vascular Section Department of Anesthesiology Anesthesiology and Critical Care Yale University School of Medicine Perelman School of Medicine New Haven, Connecticut University of Pennsylvania Philadelphia, Pennsylvania Contributors ix JOSHUA HAMBURGER, MD JOEL A. KAPLAN, MD, CPE, FACC Assistant Professor Professor of Anesthesiology Department of Anesthesiology University of California, San Diego Icahn School of Medicine at Mount Sinai La Jolla, California New York, New York Dean Emeritus School of Medicine NADIA HENSLEY, MD Former Chancellor Assistant Professor Health Sciences Center Department of Anesthesiology and Critical Care Medicine University of Louisville Johns Hopkins University School of Medicine Louisville, Kentucky Baltimore, Maryland KEYVAN KARKOUTI, MD, FRCPC, MSC BENJAMIN HIBBERT, MD, PhD Professor Assistant Professor Department of Anesthesia CAPITAL Research Group Assistant Professor Department of Cardiology Department of Health Policy, Management, and Evaluation University of Ottawa Heart Institute University of Toronto Ottawa, Ontario, Canada Scientist Toronto General Research Institute Deputy Anesthesiologist-in-Chief THOMAS L. HIGGINS, MD, MBA Anesthesia Chief Medical Offcer Toronto General Hospital Baystate Franklin Medical Center Toronto, Ontario, Canada Greenfeld, Massachusetts Chief Medical Offcer Baystate Noble Hospital JEFFREY KATZ, MD Westfeld, Massachusetts Clinical Assistant Professor Professor Anesthesia and Critical Care Department of Medicine, Anesthesia, and Surgery NorthShore University Health System Tufts University School of Medicine Evanston, Illinois Boston, Massachusetts SWAPNIL KHOCHE, MBBS JOSEPH HINCHEY, MD, PhD Assistant Clinical Professor Cardiac Anesthesia Fellow Department of Anesthesiology Anesthesiology University of California, San Diego The Mount Sinai Hospital La Jolla, California New York, New York COLLEEN G. KOCH, MD, MS, MBA CHARLES W. HOGUE, MD Mark C. Rogers Professor and Chair James E. Eckenhoff Professor of Anesthesiology Department of Anesthesiology and Critical Care Medicine Northwestern University Johns Hopkins University School of Medicine Feinberg School of Medicine Baltimore, Maryland Bluhm Cardiovascular Institute Chicago, Illinois MARK KOZAK, MD Associate Professor of Medicine JAY HORROW, MD, FAHA Heart and Vascular Institute Professor of Anesthesiology, Physiology, and Pharmacology Penn State Hershey Medical Center Drexel University College of Medicine Hershey, Pennsylvania Philadelphia, Pennsylvania GIOVANNI LANDONI, MD PHILIPPE R. HOUSMANS, MD, PhD Department of Anesthesia and Intensive Care Professor IRCCS San Raffaele Scientifc Institute Anesthesiology Professor Mayo Clinic Vita-Salute San Raffaele University Rochester, Minnesota Milan, Italy RONALD A. KAHN, MD LAEBEN LESTER, MD Professor Assistant Professor Department of Anesthesiology and Surgery Anesthesiology and Critical Care Medicine Icahn School of Medicine at Mount Sinai Division of Cardiothoracic Anesthesiology New York, New York Johns Hopkins University School of Medicine Baltimore, Maryland x Contributors JERROLD H. LEVY, MD, FAHA, FCCM TIMOTHY MAUS, MD, FASE Professor and Co-Director Associate Clinical Professor Cardiothoracic Intensive Care Unit Director of Perioperative Echocardiography Department of Anesthesiology, Critical Care, and Surgery Department of Anesthesiology Duke University School of Medicine University of California, San Diego Durham, North Carolina La Jolla, California WARREN J. LEVY, MD NANHI MITTER, MD Associate Professor Physician Specialists in Anesthesia Department of Anesthesiology and Critical Care Clinical Anesthesiologist Perelman School of Medicine Emory St. Joseph’s Hospital of Atlanta Hospital of the University of Pennsylvania Atlanta, Georgia Philadelphia, Pennsylvania ALEXANDER J.C. MITTNACHT, MD EMILIO B. LOBATO, MD Professor of Anesthesiology Staff Anesthesiologist Icahn School of Medicine at Mount Sinai North Florida/South Georgia Veterans Health Administration Director, Pediatric Cardiac Anesthesia Gainesville, Florida Department of Anesthesiology The Mount Sinai Medical Center ADAIR Q. LOCKE, MD New York, New York Assistant Professor Department of Anesthesiology CANDICE R. MONTZINGO, MD, FASE Wake Forest School of Medicine Assistant Professor Winston-Salem, North Carolina Department of Anesthesiology University of Nebraska Medical Center MARTIN J. LONDON, MD Omaha, Nebraska Professor of Clinical Anesthesia University of California, San Francisco CHRISTINA T. MORA-MANGANO, MD Veterans Affairs Medical Center Professor San Francisco, California Department of Anesthesiology, Perioperative, and Pain Medicine (Cardiac) MONICA I. LUPEI, MD Stanford University Medical Center Assistant Professor of Anesthesiology and Critical Care Medicine Stanford, California Department of Anesthesiology University of Minnesota BENJAMIN N. MORRIS, MD Minneapolis, Minnesota Assistant Professor Department of Anesthesiology MICHAEL M. MADANI, MD Wake Forest School of Medicine Professor of Cardiovascular and Thoracic Surgery Winston-Salem, North Carolina University of California, San Diego La Jolla, California J. PAUL MOUNSEY, BM BCH, PhD, FRCP, FACC Sewell Family/McAllister Distinguished Professor FEROZE MAHMOOD, MD, FASE Director, Electrophysiology Director, Cardiac Anesthesia Department of Cardiology Beth Israel Deaconess Medical Center University of North Carolina Associate Professor Chapel Hill, North Carolina Harvard Medical School Boston, Massachusetts JOHN M. MURKIN, MD, FRCPC Professor of Anesthesiology (Senate) GERARD R. MANECKE, JR., MD Schulich School of Medicine Chairman University of Western Ontario Department of Anesthesiology London, Ontario, Canada University of California, San Diego, School of Medicine San Diego, California ANDREW W. MURRAY, MBCHB Assistant Professor NICHOLAS W. MARKIN, MD, FASE Anesthesiology Assistant Professor University of Pittsburgh Department of Anesthesiology Pittsburgh, Pennsylvania University of Nebraska Medical Center Omaha, Nebraska ANDREW MASLOW, MD Professor Department of Anesthesiology Warren Alpert Brown Medical School Providence, Rhode Island