Anaes Vivas · Cardiac anaesthesia & cardiopulmonary bypass
Cardiac anaesthesia & cardiopulmonary bypass — Viva
Clinical viva on cardiac anaesthesia & cardiopulmonary bypass in anaesthetic practice.
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Target exams
ANZCAFRCAABAEDAICFCAIFCA_SA
Prompt
Post-induction cardiac theatre with the surgeon calling for heparin; TOE probe passed; ACT machine ready.
Opening
State the one-line answer first: circuit venous to arterial, heparin 300 IU/kg with ACT 400 or 480 s, wean with RRAC under TOE, protamine 1:1 slowly, restrictive transfusion when bleeding is controlled.[5][6][2][1]
References8ShowHide
- [1]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. N Engl J Med, 2017.PMID 29130845
- [2]Levy JH, Ghadimi K, Kizhakkedathu JN, Iba T What's fishy about protamine? Clinical use, adverse reactions, and potential alternatives. J Thromb Haemost, 2023.PMID 37062523
- [3]Fraile-Gutiérrez V, Pérez-Torres D, Martin-Villen L, et al. Transesophageal echocardiography: A comprehensive assessment of the critically ill patient. Med Intensiva (Engl Ed), 2026.PMID 42020231
- [4]Bottiroli M, Ortoleva J, Pisano D, et al. Perioperative Management of Patients With Durable and Temporary Left Ventricular Assist Devices Undergoing Non-Cardiac Surgery: A Comprehensive Review. J Cardiothorac Vasc Anesth, 2026.PMID 42350177
- [5]Pereira RM, Guerra N, Ferreira R, et al. Contemporary Clinical Practices in Anticoagulation Management During Cardiopulmonary Bypass: A Europe-Wide Survey. Interdiscip Cardiovasc Thorac Surg, 2026.PMID 41787968
- [6]Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr, 2013.PMID 23998692
- [7]Landoni G, Fochi O, Tritapepe L, et al. Cardiac protection by volatile anesthetics. A review. Minerva Anestesiol, 2009.PMID 18987572
- [8]Paparella D, Brister SJ, Buchanan MR Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med, 2004.PMID 15278267