Renal System

Renal dysfunction is common as a result of low cardiac output and the aggressive use of diuretics to treat congestive heart failure. The use of diuretics may also result in hyponatremia and hypokalemic metabolic alkalosis, which may require potassium replacement. Similarly, hypomagnesemia can lead to arrhythmias and may require supplemental therapy with magnesium sulfate.

Anesthetic Management

The single most important aspect of anesthetic management is to avoid further deterioration of the circulatory system, attempting to preserve the function of other organ function until cardiopulmonary bypass is started. Therefore, myo-cardial depressant drugs are avoided and increasing inotropic support may be necessary.

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