Perioperative Management
All procedures were conducted under general anesthesia, according to
standard practice, using Midazolam, Propofol or Etomidate, plus
Fentanyl, Sufentanil or Remifentanil for induction. Neuromuscular block
was achieved with induction bolus and continuous infusion of
Cisatracurium. Anesthesia was maintained by total intravenous infusion
of Propofol and Sufentanil tailored to achieve a BIS value index between
30-50. Intraoperative care, including Cardio-Pulmonary Bypass (CPB), was
managed within standard practice, thus including One Lung Ventilation
techniques as needed during surgery, ultrasound-guided vascular
cannulation, mild hypothermic with indirect anterograde cardioplegia,
and glycemic control and blood transfusions as needed by the
patient.Upon completion of surgery, all patients were transferred to
cardio-surgical intensive care unit (ICU) for monitoring, respiratory
weaning, and standard post-operative management. Sedation was maintained
by Propofol infusion as deemed necessary by on-duty intensivist.