Operative preparation of the patient for heart surgery: Airway and ventilation, vascular access and monitoring

Airway and ventilation management are key components in the perioperative management of patients with congenital heart disease. Diverse cardiovascular pathophysiology mandates individualized management, as ventilatory strategy can significantly influence cardiorespiratory interactions. Many patients with congenital heart disease have associated airway anomalies. Airway and respiratory complications are an important cause of morbidity after cardiac surgery. Inhaled nitric oxide has become a valuable treatment in the perioperative management of certain groups of patients. Establishing vascular access and invasive hemodynamic monitoring are also essential components during the perioperative period. The use of real-time ultrasound imaging has greatly increased the safety and efficiency of line placement. Other monitoring modalities such as near-infrared spectroscopy may provide additional useful information about vital organ function.