Cardiac Surgery in the Adult

1473 Pages·2011·50.26 MB·English

by  Lawrence Cohn

CARDIAC SURGERY
IN THE ADULT
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CARDIAC SURGERY
IN THE ADULT

Fourth Edition
Lawrence H. Cohn, MD
Virginia and James Hubbard Professor of Cardiac Surgery
Harvard Medical School
Division of Cardiac Surgery
Brigham and Women’s Hospital
Boston, Massachusetts

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Summary: “Cardiac Surgery in the Adult guides residents and practicing surgeons through diagnosis, treatment and management as well as operative strategy,
decision-making, and technique in adult cardiac surgery. Developments in this fi eld are constant and are in line with the surgical trends at large: less-invasive surgery
with faster recovery times. Developments in this fi eld include the use of robotic surgery, minimally invasive valve and coronary artery bypass surgery, stem-cell induced
regenerative medicine, tissue engineering and more, all of which are discussed and completely updated. Trends also take into account the demographics of the patient with
an eye toward cross-training the surgeon in endovascular skills by including topics such as percutaneous intervention and endovascular graft technology.”—Provided by
publisher.
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If I have seen further it is by standing on the shoulders of giants.
—Sir Isaac Newton
I dedicate this edition, to my mentors:
Norman E. Shumway, MD
Andrew Glenn Morrow, MD
Eugene Braunwald, MD
J. Englebert Dunphy, MD
Francis D. Moore, MD
John J. Collins, Jr., MD
John A. Mannick, MD
All who have influenced me in different ways to become the cardiac surgeon I am today.
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CONTENTS
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxi
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxiii
PART 1
FUNDAMENTALS
1. History of Cardiac Surgery . . . . . . . . . . . . 3 6. Computed Tomography of the
Larry W. Stephenson, Adult Cardiac Surgery Patient:
Frank A. Baciewicz, Jr. Principles and Applications . . . . . . . . . 149
Frank J. Rybicki, Tarang Sheth, Kanako K.
2. Surgical Anatomy of the Heart . . . . . . . . 21
Kumamaru, Frederick Y. Chen
Michael R. Mill, Robert H. Anderson,
Lawrence H. Cohn 7. Assessment of Cardiac Operations to
Improve Performance . . . . . . . . . . . . . 171
3. Cardiac Surgical Physiology . . . . . . . . . . 43
Victor A. Ferraris, Fred H. Edwards,
Edward B. Savage, Robert Saeid Farivar
David M. Shahian
4. Cardiac Surgical Pharmacology . . . . . . . 69
8. Statistical Treatment of Surgical
Jerrold H. Levy, Kenichi A. Tanaka,
Outcome Data . . . . . . . . . . . . . . . . . . . 199
James G. Ramsay
Ruyun Jin, Gary L. Grunkemeier
5. Cardiovascular Pathology . . . . . . . . . . . . 95
Frederick J. Schoen, Robert F. Padera
PART 2
PERIOPERATIVE/INTRAOPERATIVE CARE
9. Preoperative Evaluation for 11. Echocardiography in Cardiac Surgery . . . 253
Cardiac Surgery . . . . . . . . . . . . . . . . . . 213 Maurice Enriquez-Sarano, Vuyisile T. Nkomo,
Christian T. Ruff, Patrick T. O’Gara Hector I. Michelena
10. Cardiac Anesthesia . . . . . . . . . . . . . . . . 223 12. Extracorporeal Circulation . . . . . . . . . . . . 283
William J. Vernick, Albert T. Cheung, John W. Hammon, Michael H. Hines
Jeremy D. Kukafka, Joseph E. Savino
vii
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viii Contents
13. Transfusion Therapy and Blood 16. Postoperative Care of Cardiac
Conservation . . . . . . . . . . . . . . . . . . . . 331 Surgery Patients . . . . . . . . . . . . . . . . . . 381
Leonard Y. Lee, William J. DeBois, Zain I. Khalpey, Jan D. Schmitto,
Karl H. Krieger, O. Wayne Isom James D. Rawn
14. Deep Hypothermic Circulatory Arrest . . 343 17. Cardiopulmonary Resuscitation . . . . . . 401
Andrew W. El Bardissi, Robert A. Oakes, Mark P. Anstadt, James E. Lowe
R. Morton Bolman III
18. Temporary Mechanical
15. Myocardial Protection . . . . . . . . . . . . . 355 Circulatory Support . . . . . . . . . . . . . . . . 417
Robert M. Mentzer, Jr., Roberta A. Gottlieb, Edwin C. McGee, Jr.,
Karin Przyklenk, M. Salik Jahania Nader Moazami
PART 3
ISCHEMIC HEART DISEASE
19. Indications for Revascularization . . . . . 441 26. Coronary Artery Reoperations . . . . . . . 567
Morgan L. Brown, Thoralf M. Sundt III G. V. Gonzalez-Stawinski,
Bruce W. Lytle
20. Myocardial Revascularization with
Percutaneous Devices . . . . . . . . . . . . . 461 27. Transmyocardial Laser
James M. Wilson, James T. Willerson Revascularization and Extravascular
Angiogenetic Techniques to Increase
21. Myocardial Revascularization with
Myocardial Blood Flow . . . . . . . . . . . . . 585
Cardiopulmonary Bypass . . . . . . . . . . . 479
Keith A. Horvath, Yifu Zhou
Kevin L. Greason, Thoralf M. Sundt III
28. Surgical Treatment of Complications
22. Myocardial Revascularization without
of Acute Myocardial Infarction:
Cardiopulmonary Bypass . . . . . . . . . . . 505
Postinfarction Ventricular Septal
Michael E. Halkos, John D. Puskas
Defect and Free Wall Rupture . . . . . . . 603
23. Myocardial Revascularization Arvind K. Agnihotri, Joren C. Madsen,
with Carotid Artery Disease . . . . . . . . . 523 Willard M. Daggett, Jr.
Cary W. Akins, Richard P. Cambria
29. Ischemic Mitral Regurgitation . . . . . . . 629
24. Myocardial Revascularization after Acute Pavan Atluri, Robert C. Gorman, Joseph H.
Myocardial Infarction . . . . . . . . . . . . . . 535 Gorman III, Michael A. Acker
Isaac George, Mathew Williams
30. Left Ventricular Aneurysm . . . . . . . . . . 647
25. Minimally Invasive Myocardial Donald D. Glower, James E. Lowe
Revascularization . . . . . . . . . . . . . . . . . 553
David M. Holzhey, Ardawan J. Rastan,
Volkmar Falk, Friedrich W. Mohr
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Contents ix
PART 4 A
VALVULAR HEART DISEASE (AORTIC)
31. Pathophysiology of Aortic 35. Aortic Valve Replacement with
Valve Disease . . . . . . . . . . . . . . . . . . . . 665 a Stentless Bioprosthetic Valve:
Craig M. Jarrett, Samuel Edwards, Porcine or Pericardial . . . . . . . . . . . . . . 741
A. Marc Gillinov, Tomislav Mihaljevic Edward H. Kincaid, Neal D. Kon
32. Aortic Valve Replacement 36. Aortic Valve Repair and Aortic
with a Mechanical Cardiac Valve-Sparing Operations . . . . . . . . . . . 753
Valve Prosthesis . . . . . . . . . . . . . . . . . . 679 Tirone E. David
Robert W. Emery, Ann M. Emery,
37. Surgical Treatment of Aortic
Jan Hommerding, Goya V. Raikar
Valve Endocarditis . . . . . . . . . . . . . . . . 767
33. Bioprosthetic Aortic Valve Tirone E. David
Replacement: Stented Pericardial
38. Minimally Invasive Aortic
and Porcine Valves . . . . . . . . . . . . . . . . 695
Valve Surgery . . . . . . . . . . . . . . . . . . . . 775
Bobby Yanagawa, George T. Christakis
Prem S. Shekar, Lawrence H. Cohn
34. Stentless Aortic Valve Replacement:
39. Percutaneous Treatment of
Autograft/Homograft . . . . . . . . . . . . . . 723
Aortic Valve Disease . . . . . . . . . . . . . . . 783
Paul Stelzer, Robin Varghese
Lars G. Svensson
PART 4 B
VALVULAR HEART DISEASE (MITRAL)
40. Pathophysiology of Mitral 44. Minimally Invasive and Robotic Mitral
Valve Disease . . . . . . . . . . . . . . . . . . . . 793 Valve Surgery . . . . . . . . . . . . . . . . . . . . 887
James I. Fann, Neil B. Ingels, Jr., Eric J. Lehr, Evelio Rodriguez, W. Randolph
D. Craig Miller Chitwood, Jr.
41. Mitral Valve Repair . . . . . . . . . . . . . . . . 829 45. Percutaneous Catheter-Based
Frederick Y. Chen, Lawrence H. Cohn Mitral Valve Repair . . . . . . . . . . . . . . . . 911
Michael J. Mack
42. Mitral Valve Replacement . . . . . . . . . . 849
Robert P. Gallegos, Tomas Gudbjartsson,
Sary Aranki
43. Surgical Treatment of Mitral Valve
Endocarditis . . . . . . . . . . . . . . . . . . . . . 877
Gosta B. Pettersson, A. Marc Gillinov,
Sotiris C. Stamou
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