Recommendations   Class   Level   References
Monitoring
The introduction of an arterial line in advance of anaesthesia induction is recommended.  I  C  [214–216]
Use of a central venous line is recommended.  I  C  [214–216]
A pulmonary artery catheter should be considered.  IIa  C  [222–224]
Neuromonitoring with electroencephalography may be considered.  IIb  C  [225]
Neuromonitoring with near infrared spectroscopy should be considered, especially in off-pump implantation.  IIa  C  [243]
Periprocedural transoesophageal echocardiography
It is recommended that the following assessments be performed using periprocedural transoesophageal echocardiography: intracavitary thrombus identification, detection of patent foramen ovale and other intracardiac shunts, assessment of aortic regurgitation, right ventricle assessment, inflow cannula positioning and outflow cannula positioning.  I  C  [230]
Assessment of right ventricular failure
Transoesophageal echocardiography guidance for weaning from CPB/extracorporeal life support is recommended.  IIa  C
iNO, milrinone and phosphodiesterase type 5 inhibitors to lower pulmonary vascular resistance should be considered.  IIa  B  [236, 244–246]