Anesthesia affects the physiology of each patient and most especially the cardiovascular system is affected. Therefore understanding the physiology of the cardiovascular system allows a better understanding of the changes occurring under anesthesia, enabling recognition and effective treatment of the adverse events. This review has addressed the points that are important to anesthesiologists in cardiac physiology.

INTRODUCTION: Thoracic epidural analgesia (TEA) is a method used for postoperative pain management in thoracic surgery patients. In our study, in patients with postoperative TEA method thoracotomy, we compared the effects of fentanyl and local anesthetic drugs on hemodynamics and pain scores.
METHODS: 80 patients undergoing thoracotomy were divided into 4 groups. In patients groups for postoperative TEA was administered fentanyl, fentanyl + ropivacaine, fentanyl + bupivacaine, fentanyl + levobupivacaine. Hemodynamic data and pain scores were recorded.
RESULTS: Levobupivacaine in combination with fentanyl, providing a more effective analgesia compared to ropivacaine and bupivacaine.
DISCUSSION AND CONCLUSION: TEA is extremely important for the patient's sufficient respiratory effort and lung expansion in the postoperative period. It was concluded that after many painful procedures such as thoracotomy in thoracic epidural use of fentanyl together with local anesthetics provides more effective analgesia. Compared to other groups levobupivacaine+fentanyl analgesia was more effective.

INTRODUCTION: To investigate pediatric cases undergoing open heart surgery due to congenital heart disease.
METHODS: Pediatric cases undergoing congenital open heart surgery between November 2013 and March 2015 were retrospectively reviewed.
RESULTS: 17 of the cases were male and 23 of them were female. 52.5% of these cases were newborns. Surgery process was performed with cardiopulmonary bypass in %50 of all cases. %75 of the cases operated with CBP were applied with blood cardioplegia while %25 of them were applied with the histidine-tryptophan-ketoglutarate solution.
DISCUSSION AND CONCLUSION: Anesthetic problems encountered in a new pediatric cardiac surgery centers were: lack of experienced technicians, medical supplies, and catheterization procedure problems.

Tracheal stenosis is airway obstruction caused by congenital, acquired and idiopathic. The most common etiology is intubation or tracheostomy due to prolonged mechanical ventilation. Tracheal stenosis due to intubation occurs as a result that the endotracheal cuff pressure exceeds the mean capillary-arteriolar blood pressure in tracheal mucosa. Interventional bronchoscopic procedures have commonly used in recent years for both diagnosis and treatment because of low complication rates in selected patients. In particular, by rapid induction of anesthesia, it is possible to have controlled airway and ventilation during rigid bronchoscopy performed under general anesthesia. In particular, the rigid bronchoscopy performed under general anesthesia, providing a controlled airway and ventilation, with a rapid induction of anesthesia procedures that ensure adequate muscle relaxation is performed. In this paper, total intravenous anesthesia management under the application of the ballon dilatation along with rigid bronchoscopy is presented in four cases with tracheal stenosis due to intubation.

Bronchopleural fistula is a complication that can occur early and late period after pulmonary resection. They are more frequent after right pneumonectomy operations. Several perioperative factors are associated with an increased incidence of bronchopleural fistula after pneumonectomy. Chest x-ray, computed tomography, and nuclear medicine techniques are among means of diagnosis. In addition, bronchoscopy can also be used for diagnosis as well as for treatment. Especially, bronchoscopy is capable of producing successful results in small bronchopleural fistula. Rigid bronchoscopic interventions are usually performed under general anesthesia with total intravenous anesthesia as first choice. Using the quick onset of action and short-acting drug is advantageous both during and after the operation. Complete return of the effect of muscle relaxants used in general anesthesia is important during the recovery. Specifically, usage of Sugammadex improves the recovery by quick return of respiratory function. In this paper, formation of bronchopleural fistula, its risk factors, bronchoscopic treatment and anesthesia management is presented.

We present a case of premature coagulation in the bypass pump circuit. Fifty-nine years-old female (Euroscore: 5) presented with acute heart failure and pulmonary oedema due to mitral valve stenosis. Following one vessel coronary bypass and mitral valve replacement (cross clamp time: 170 minutes), the blood collected before heparinization had to be transfused due to persistent bleeding. A short while after the transfusion, we had to initiate the backup bypass machine due to coagulation in the pump circuit. We are in opinion that the whole blood with fresh coagulation factors activated the intrinsic pathway in the pump circuit and caused the coagulation.