Anesthesia Management
Following our institutional protocol, anesthesia was induced with fentanyl, propofol, and rocuronium and was maintained with sevoflurane and fentanyl. Lungs were ventilated mechanically with a tidal volume of 6 to 8 mL/kg with a positive end-expiratory pressure of ≥ 5 mbar, maintaining normoxia and normocapnia. Patients were restricted to a maximum of 500 mL of balanced crystalloid infusion till intraoperative echocardiography. All echocardiographic measurements were performed without any influence of inotropic or vasopressor support and pacing. All echocardiographic studies were performed under stable hemodynamics and in sinus rhythm. Following the standards of our institutional hemodynamics protocol mean arterial blood pressure (MAP) and central venous pressure (CVP) were maintained establishing stable hemodynamics (MAP 60-80 mmHg, CVP 4-12 mmHg).