The care of cardiac surgical patients in the intensive care unit (CTICU) has evolved into a highly demanding specialty in modern medical practice. Practitioners are responsible for the management of patients undergoing coronary artery bypass grafting (CABG), valvular heart procedures, aortic dissection repair, and those requiring mechanical circulatory support. A comprehensive understanding of the various consequences associated with these procedures is essential. This includes the effects of cardiopulmonary bypass, management of mechanical circulatory support, addressing bleeding complications, arrhythmias, and the treatment of endocarditis. These challenges require a multidisciplinary approach and the use of specialized tools for monitoring and supporting these critically ill patients. In this chapter, we will explore the fundamental concepts of managing cardiac surgical patients in the ICU. This includes the critical care protocols, monitoring systems, and therapeutic strategies employed to ensure optimal patient outcomes.