BOOK
Sabiston and Spencer Surgery of the Chest E-Book
Frank Sellke | Pedro J. del Nido | Scott J. Swanson
(2015)
Additional Information
Book Details
Abstract
For complete, authoritative coverage of every aspect of thoracic and cardiac surgery, turn to the unparalleled guidance found in Sabiston and Spencer Surgery of the Chest, 9th Edition. Now in full-color for the first time, Drs. Frank W. Sellke, Pedro J. del Nido, and Scott J. Swanson’s standard-setting set is meticulously organized so that you can quickly find expert information on open and endoscopic surgical techniques performed in the operating room. With its comprehensive coverage of thoracic as well as adult and pediatric cardiac surgery, this 9th Edition is an essential resource not only for all thoracic surgeons, but also for physicians, residents, and students concerned with diseases of the chest.
- Find what you need quickly with short, focused chapters divided into three major sections: Adult Cardiac Surgery, Pediatric Cardiac Surgery, and Thoracic Surgery.
- Benefit from the knowledge and expertise of global experts who provide a comprehensive view of the entire specialty.
- Master all of the most important current knowledge and techniques in cardiac and thoracic surgery—whether for specialty board review or day-to-day surgical practice.
- Visualize challenging surgical techniques and procedures and navigate the text more efficiently thanks to an all-new, full-color design.
- Stay up to date with revised or all-new chapters including Critical Care for War-related Thoracic Surgery; Neuromonitoring and Neurodevelopment Outcomes in Congenital Heart Surgery; and Quality Improvement: Surgical Performance.
- Keep abreast of cutting-edge topics such as endovascular stenting and cell-based therapies, as well as the latest innovations in imaging and diagnosis, minimally invasive cardiothoracic surgery, and percutaneous devices.
- Sharpen your surgical skills with access to 21 procedural videos online, including 3 new videos covering Surgical Technique-VATS Sympathetic Block; Open pneumothorax; and Extent II repair of thoracoabdominal aortic aneurysm.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| e9780323393775v1 | 1 | ||
| Front Cover | 1 | ||
| Volume1_EP2 | 2 | ||
| Sabiston and Spencer Surgery of the Chest | 3 | ||
| Copyright Page | 6 | ||
| Dedication | 7 | ||
| Contributors | 8 | ||
| Preface | 25 | ||
| Table Of Contents | 26 | ||
| Video Contents | 31 | ||
| 1 Thoracic Surgery | 35 | ||
| A Evaluation and Care | 36 | ||
| 1 Anatomy of the Thorax | 37 | ||
| Chapter Outline | 37 | ||
| Thoracic Cage | 37 | ||
| Thoracic Inlet | 37 | ||
| Cervicoaxillary Canal | 37 | ||
| Diaphragm | 38 | ||
| Bony Thoracic Cage | 39 | ||
| Sternum | 39 | ||
| Ribs | 40 | ||
| Muscles of the Thorax | 40 | ||
| Intercostal Muscles | 40 | ||
| Anatomy of Breathing | 44 | ||
| Surface Anatomy | 44 | ||
| Mediastinum | 47 | ||
| Tracheobronchial Tree | 48 | ||
| Lungs | 49 | ||
| Esophagus | 55 | ||
| Vessels of the Thorax | 57 | ||
| Descending Thoracic Aorta | 57 | ||
| Azygos Vein | 57 | ||
| Thoracic Duct | 58 | ||
| Nerves of the Thorax | 58 | ||
| Vagus and Recurrent Laryngeal Nerves | 58 | ||
| Thoracic Sympathetic Chain | 58 | ||
| Phrenic Nerves | 58 | ||
| Suggested Readings | 59 | ||
| 2 Radiologic Imaging of Thoracic Abnormalities | 60 | ||
| Chapter Outline | 60 | ||
| Mediastinal Abnormalities | 60 | ||
| Aorta | 60 | ||
| Aortic Dissection | 60 | ||
| Aortic Trauma | 61 | ||
| Trauma: Airways and Esophagus | 62 | ||
| Evaluation of Airways: Nontrauma | 63 | ||
| Mediastinal Tumors | 63 | ||
| Lung Abnormalities | 64 | ||
| Solitary Pulmonary Opacities | 64 | ||
| Staging Lung Cancer | 64 | ||
| Interstitial Lung Disease and Pulmonary Abscesses | 67 | ||
| Pleural and Chest Wall Abnormalities | 67 | ||
| Malignant Pleural Mesothelioma | 67 | ||
| Pleural Collections | 68 | ||
| Chest Wall Disease | 68 | ||
| Postoperative Imaging | 69 | ||
| Pulmonary Embolism | 69 | ||
| Summary | 70 | ||
| References | 70 | ||
| 3 Preoperative Evaluation of Patients Undergoing Thoracic Surgery | 73 | ||
| Chapter Outline | 73 | ||
| Physiologic Effects of Thoracic Surgery | 73 | ||
| Patient Population Undergoing Thoracic Surgery | 74 | ||
| Common Complications after Thoracic Surgery | 74 | ||
| Effect of Surgical Approach on Perioperative Complications | 74 | ||
| Goals of the Preoperative Evaluation | 74 | ||
| History and Physical Examination | 75 | ||
| History | 75 | ||
| Physical Examination | 75 | ||
| Laboratory Studies | 76 | ||
| Imaging Studies | 76 | ||
| Pulmonary Function Testing | 76 | ||
| Prediction of Postoperative Lung Function | 76 | ||
| Cardiac Assessment of Patients Under Consideration for Thoracic Surgical Procedures | 77 | ||
| Assessment of Functional Capacity | 78 | ||
| Arterial Blood Gas Measurements | 78 | ||
| Pulmonary Hemodynamics | 78 | ||
| Age | 79 | ||
| Evaluation and Risk Stratification | 79 | ||
| References | 79 | ||
| 4 Perioperative Care of the Thoracic Surgical Patient | 81 | ||
| Chapter Outline | 81 | ||
| Preoperative Preparation | 82 | ||
| Prophylaxis | 83 | ||
| Atrial Fibrillation | 83 | ||
| Deep Venous Thrombosis | 83 | ||
| Stress Ulceration and Gastritis | 83 | ||
| Infection | 84 | ||
| Anticoagulation | 86 | ||
| Miscellaneous | 86 | ||
| Intraoperative Care | 87 | ||
| Ventilation | 87 | ||
| Monitoring | 87 | ||
| Body Temperature | 87 | ||
| Positioning | 87 | ||
| Fluid Administration | 88 | ||
| Drainage | 88 | ||
| Specimen Management | 88 | ||
| Postoperative Care | 88 | ||
| Fluid Management | 88 | ||
| Blood Administration | 89 | ||
| Medications | 89 | ||
| Analgesia | 90 | ||
| Nutrition | 90 | ||
| Respiratory Therapy | 91 | ||
| Wound Care | 91 | ||
| Management of Drainage Tubes | 92 | ||
| Physical Therapy | 93 | ||
| Management of Complications | 93 | ||
| Early Complications | 93 | ||
| Respiratory Complications | 93 | ||
| Atelectasis and Pneumonia. | 93 | ||
| Prolonged Air Leak. | 93 | ||
| Pulmonary Edema. | 93 | ||
| Acute Respiratory Distress Syndrome. | 94 | ||
| Cardiac Complications | 94 | ||
| Myocardial Infarction. | 94 | ||
| Atrial Fibrillation. | 94 | ||
| Bleeding | 94 | ||
| Late Complications | 95 | ||
| Pulmonary Complications | 95 | ||
| Bronchopleural Fistula. | 95 | ||
| Bronchovascular Fistula. | 96 | ||
| Postpneumonectomy Syndrome. | 97 | ||
| Wound Infection and Empyema. | 97 | ||
| Post-thoracotomy Pain. | 97 | ||
| Complications after Esophageal Surgery | 98 | ||
| Dysphagia | 98 | ||
| Anastomotic Leak | 98 | ||
| Stricture | 98 | ||
| Conduit Ischemia | 98 | ||
| Recurrent Laryngeal Nerve Damage | 99 | ||
| Chylothorax | 99 | ||
| Functional Problems | 99 | ||
| Reflux | 100 | ||
| Miscellaneous | 100 | ||
| Discharge Planning | 100 | ||
| References | 100 | ||
| B Endoscopy | 105 | ||
| 5 Endoscopic Diagnosis of Thoracic Disease | 106 | ||
| Chapter Outline | 106 | ||
| Esophagoscopy | 106 | ||
| Indications | 106 | ||
| Preprocedure | 107 | ||
| Flexible Esophagoscopy | 107 | ||
| Technique | 107 | ||
| Complications | 108 | ||
| Rigid Esophagoscopy | 108 | ||
| Endoscopic Ultrasound | 108 | ||
| Tracheobronchoscopy | 108 | ||
| Indications | 109 | ||
| Endobronchial Ultrasound | 110 | ||
| Navigational Bronchoscopy | 110 | ||
| Flexible Bronchoscopy | 110 | ||
| Technique | 110 | ||
| Complications | 111 | ||
| Rigid Bronchoscopy | 111 | ||
| Technique | 111 | ||
| Complications | 112 | ||
| References | 112 | ||
| 6 Endoscopic Therapies for Thoracic Diseases | 113 | ||
| Chapter Outline | 113 | ||
| Photodynamic Therapy | 113 | ||
| Definition and Mechanism of Action | 113 | ||
| Technique | 114 | ||
| Contraindications | 114 | ||
| Lung Cancer | 114 | ||
| Curative Intent | 114 | ||
| Palliative Intent | 115 | ||
| Barrett Esophagus and Esophageal Cancer | 116 | ||
| Curative Intent | 116 | ||
| Palliative Intent | 118 | ||
| Laser Ablation of Endoluminal Tumors | 118 | ||
| Airway | 119 | ||
| Esophagus | 119 | ||
| Brachytherapy | 119 | ||
| Stents | 120 | ||
| e9780323393775v2 | 1226 | ||
| Front Cover | 1226 | ||
| Sabiston and Spencer Surgery of the Chest | 1227 | ||
| Copyright Page | 1230 | ||
| Dedication | 1231 | ||
| Contributors | 1232 | ||
| Preface | 1249 | ||
| Table Of Contents | 1250 | ||
| Video Contents | 1255 | ||
| 2\r Adult Cardiac Surgery | 1259 | ||
| E Surgical Management of Aortic Disease | 1259 | ||
| 67 Surgery of the Aortic Root and Ascending Aorta | 1260 | ||
| Chapter Outline | 1260 | ||
| Functional Anatomy of the Aortic Root | 1260 | ||
| Pathology of the Aortic Root and Ascending Aorta | 1262 | ||
| Degenerative Aneurysms of the Proximal Aorta | 1263 | ||
| Inherited Aneurysms of the Proximal Aorta | 1264 | ||
| Marfan Syndrome | 1264 | ||
| Loeys-Dietz Syndrome | 1266 | ||
| Ehlers-Danlos Syndrome | 1266 | ||
| Bicuspid Aortic Valve Disease | 1266 | ||
| Atherosclerosis | 1267 | ||
| Infectious Aneurysms | 1267 | ||
| Aortitis | 1267 | ||
| Aortic Dissection | 1267 | ||
| Ascending Aorta Tumors | 1267 | ||
| Ascending Aorta Trauma | 1267 | ||
| Surgical Treatment of Ascending Aortic Aneurysm | 1267 | ||
| Operative Techniques | 1268 | ||
| Clinical Outcomes | 1270 | ||
| Surgical Treatment of Aortic Root Aneurysms | 1271 | ||
| Operative Techniques | 1271 | ||
| Remodeling of the Aortic Root | 1271 | ||
| Reimplantation of the Aortic Valve | 1272 | ||
| Aortic Root Replacement | 1272 | ||
| Clinical Outcomes | 1273 | ||
| Ross Procedure | 1274 | ||
| Operative Techniques | 1275 | ||
| Subcoronary Implantation | 1275 | ||
| Aortic Root Replacement | 1275 | ||
| Aortic Root Inclusion | 1275 | ||
| Clinical Outcomes | 1277 | ||
| References | 1277 | ||
| 68 Surgery of the Aortic Arch | 1281 | ||
| Chapter Outline | 1281 | ||
| Definitions and Classification | 1281 | ||
| Causative and Predisposing Factors | 1282 | ||
| Congenital Aneurysms | 1282 | ||
| Medial Degenerative Aneurysms | 1283 | ||
| Aortic Dissection | 1283 | ||
| Mycotic Aneurysms | 1283 | ||
| Vasculitis and Aortitis | 1284 | ||
| Trauma | 1285 | ||
| Tumors of the Arch | 1286 | ||
| Reoperations | 1286 | ||
| Syndromes Associated with Aortic Arch Pathology | 1287 | ||
| History and Physical Examination | 1287 | ||
| Preoperative Studies | 1288 | ||
| Cardiopulmonary Perfusion Aspects | 1288 | ||
| Brain Protection | 1290 | ||
| Primum non nocere: First Do No Harm | 1290 | ||
| Prevention of Stroke | 1291 | ||
| Prevention of Neurocognitive Deficits | 1292 | ||
| Operative Techniques | 1294 | ||
| Hemiarch Replacement | 1294 | ||
| Replacement of the Entire Aortic Arch | 1295 | ||
| Other Techniques | 1300 | ||
| Frozen Elephant Trunk | 1301 | ||
| Outcomes | 1301 | ||
| Summary | 1303 | ||
| References | 1303 | ||
| 69 Descending Thoracic and Thoracoabdominal Aortic Surgery | 1306 | ||
| Chapter Outline | 1306 | ||
| Introduction | 1306 | ||
| Developing a Surgical Approach to Repair | 1307 | ||
| Natural History | 1307 | ||
| Classification by Extent of Repair | 1307 | ||
| Causes and Predisposing Factors | 1308 | ||
| Nonspecific Medial Degeneration | 1308 | ||
| Chronic Aortic Dissection | 1308 | ||
| Connective Tissue and Genetic Disorders | 1309 | ||
| Aortitis | 1310 | ||
| Mycotic Aneurysm | 1310 | ||
| Repair after Previous Open Aortic Repair (Noncongenital) | 1310 | ||
| Repair after Previous Endovascular Aortic Repair | 1310 | ||
| Coarctation in the Adult (Congenital) | 1311 | ||
| Indications for Repair | 1311 | ||
| Diagnostic Imaging Evaluation | 1312 | ||
| Diameter-Based Thresholds for Repair | 1313 | ||
| Symptoms | 1314 | ||
| Contraindications to Repair | 1315 | ||
| Strategy for Repair | 1315 | ||
| Preoperative Evaluation | 1315 | ||
| Cardiac Function | 1315 | ||
| Pulmonary Function | 1315 | ||
| Renal Function | 1316 | ||
| Evaluation of Imaging Studies | 1316 | ||
| Anesthesia | 1316 | ||
| Positioning | 1317 | ||
| Multimodal Strategy Based on Extent of Repair | 1317 | ||
| Left Heart Bypass | 1317 | ||
| Visceral Protection | 1317 | ||
| Spinal Cord Protection | 1318 | ||
| Renal Protection | 1319 | ||
| Hypothermia | 1319 | ||
| Operative Technique | 1320 | ||
| Exposure | 1320 | ||
| Proximal Anastomosis | 1321 | ||
| Reattachment Strategies and Other Considerations | 1321 | ||
| Distal Anastomosis | 1325 | ||
| Elephant Trunk Approaches | 1325 | ||
| Open Repair after Endovascular Aortic Repair | 1329 | ||
| Closure | 1330 | ||
| Postoperative Management | 1330 | ||
| Immediate Postoperative Management | 1330 | ||
| Long-Term Management | 1331 | ||
| Outcomes | 1331 | ||
| Descending Thoracic Aortic Aneurysm Repair | 1332 | ||
| Thoracoabdominal Aortic Aneurysm Repair | 1332 | ||
| Acknowledgments | 1332 | ||
| Disclosure | 1332 | ||
| Funding | 1333 | ||
| References | 1333 | ||
| 70 Type A Aortic Dissection | 1336 | ||
| Chapter Outline | 1336 | ||
| Historical Note | 1337 | ||
| Classification | 1337 | ||
| Epidemiology | 1338 | ||
| Natural History | 1339 | ||
| Predisposing Factors | 1340 | ||
| Hypertension | 1340 | ||
| Connective Tissue Disorders | 1340 | ||
| Congenital Abnormalities | 1340 | ||
| Iatrogenic Injury | 1341 | ||
| Pregnancy | 1341 | ||
| Illicit Drug Related | 1341 | ||
| Other Associations | 1341 | ||
| Pathophysiology and Pathologic Findings | 1341 | ||
| Medial Degeneration | 1341 | ||
| Primary Intimal Tear | 1342 | ||
| Propagation and Reentry | 1342 | ||
| Intramural Hematoma | 1343 | ||
| Aortic Branch Compromise | 1343 | ||
| Clinical Manifestations | 1344 | ||
| Patient Characteristics | 1344 | ||
| Acute Type A Dissection | 1344 | ||
| Pain | 1344 | ||
| Systemic Manifestations | 1344 | ||
| Cardiovascular Manifestations | 1344 | ||
| Peripheral Vascular Complications | 1345 | ||
| Chronic Type A Dissection | 1346 | ||
| Diagnostic Modalities | 1346 | ||
| Aortography | 1346 | ||
| Computed Tomography | 1347 | ||
| Magnetic Resonance Imaging | 1347 | ||
| Echocardiography | 1347 | ||
| Diagnostic Strategy at Stanford University and Special Diagnostic Considerations | 1348 | ||
| Stanford Diagnostic Strategy | 1348 | ||
| Intramural Hematoma | 1348 | ||
| Coronary Angiography | 1348 | ||
| Biomarkers | 1349 | ||
| Management | 1349 | ||
| Acute Type A Dissection | 1349 | ||
| Surgical Principles | 1350 | ||
| Technical Considerations | 1350 | ||
| Operative Technique | 1351 | ||
| More Radical Management of the Aortic Root | 1354 | ||
| Management of the Aortic Arch | 1354 | ||
| Distal Frozen Elephant Trunk Graft | 1354 | ||
| Special Situations | 1355 | ||
| Primary Intimal Tear in the Descending Thoracic Aorta (Retro-A Dissection). | 1355 | ||
| Type A Aortic Dissection and Coarctation. | 1355 | ||
| Postoperative Malperfusion. | 1355 | ||
| Chronic Type A Dissections | 1355 | ||
| Indications for Operative Intervention | 1355 | ||
| Surgical Technique | 1356 | ||
| Results | 1356 | ||
| Early Survival | 1356 | ||
| Late Survival | 1357 | ||
| Reoperation | 1359 | ||
| Follow-up | 1360 | ||
| References | 1360 | ||
| 71 Type B Aortic Dissection | 1366 | ||
| Chapter Outline | 1366 | ||
| Historical Note | 1366 | ||
| Nomenclature | 1367 | ||
| Epidemiology and Natural History | 1367 | ||
| Epidemiology | 1367 | ||
| Natural History | 1367 | ||
| Pathophysiology | 1368 | ||
| Clinical Manifestations | 1369 | ||
| Diagnostic Modalities | 1371 | ||
| Management | 1372 | ||
| Strategy | 1372 | ||
| Initial Medical Treatment | 1373 | ||
| Definitive Long-term Medical Management | 1373 | ||
| Operative Approach | 1373 | ||
| Acute Type B Dissections | 1373 | ||
| Management of Peripheral Vascular Complications | 1374 | ||
| Endovascular Stent Grafts | 1374 | ||
| Chronic Type B Dissections | 1375 | ||
| Results | 1375 | ||
| Comparison of Results of Surgical and Medical Treatment | 1375 | ||
| Historical Perspective | 1375 | ||
| Contemporary Comparative Studies of Surgical versus Medical Treatment | 1376 | ||
| Current Results | 1376 | ||
| Early Survival | 1376 | ||
| Late Survival | 1377 | ||
| Aortic Reintervention | 1377 | ||
| Follow-Up | 1378 | ||
| References | 1379 | ||
| 72 Endovascular Therapy for the Treatment of Thoracic Aortic Pathologies | 1382 | ||
| Chapter Outline | 1382 | ||
| Descending Thoracic Aortic Aneurysms | 1383 | ||
| Natural History and Indications for Intervention | 1383 | ||
| Device Development | 1383 | ||
| Gore TAG | 1383 | ||
| Medtronic Talent and Valiant Thoracic Endoprosthesis | 1384 | ||
| The Talent Device. | 1384 | ||
| The Valiant Device. | 1384 | ||
| Cook Zenith TX2 Thoracic Endoprosthesis. | 1385 | ||
| Bolton Relay Prosthesis. | 1385 | ||
| Anatomic and Technical Considerations | 1385 | ||
| Access | 1386 | ||
| Landing Zones | 1387 | ||
| Results | 1388 | ||
| Multicenter Clinical Trials | 1388 | ||
| European Registries | 1389 | ||
| Complications | 1389 | ||
| Vascular Access | 1389 | ||
| Endoleak | 1389 | ||
| Neurologic Complications | 1389 | ||
| Aortic Dissections | 1390 | ||
| Natural History and Indications for Intervention | 1390 | ||
| Classification | 1391 | ||
| Indications for Intervention | 1391 | ||
| Anatomic and Technical Considerations | 1391 | ||
| Results | 1392 | ||
| Uncomplicated Type B Dissection | 1392 | ||
| Complicated Type B Dissection | 1393 | ||
| Penetrating Atherosclerotic Ulcer, Intramural Hematoma, and Blunt Thoracic Aortic InJury | 1394 | ||
| Aortic Arch/Ascending Aortic Pathologies | 1394 | ||
| Aortic Arch Endovascular Repair | 1394 | ||
| Landing Zones | 1394 | ||
| Outcomes | 1395 | ||
| Ascending Aorta Endovascular Repair | 1395 | ||
| Summary | 1395 | ||
| References | 1396 | ||
| 73 Occlusive Disease of the Brachiocephalic Vessels and Management of Simultaneous Surgical Carotid and Coronary Disease | 1398 | ||
| Chapter Outline | 1398 | ||
| Occlusive Disease Involving the Brachiocephalic Arteries | 1399 | ||
| Pathophysiology | 1399 | ||
| Clinical Presentation | 1399 | ||
| Diagnostic Evaluation | 1400 | ||
| Conventional Imaging Modalities | 1400 | ||
| Ultrasonography and Emerging Imaging Modalities | 1401 | ||
| Anatomic Considerations in Operative Exposures of Brachiocephalic Vessels | 1401 | ||
| Treatment | 1402 | ||
| Innominate Artery Occlusive Disease | 1402 | ||
| Innominate Artery Endarterectomy. | 1403 | ||
| Innominate Artery Bypass. | 1403 | ||
| Innominate Artery Stenting. | 1404 | ||
| Common Carotid Artery Occlusive Disease | 1404 | ||
| Common Carotid Artery Bypass. | 1404 | ||
| Carotid Endarterectomy with Retrograde Stenting of the Innominate or Left Common Carotid Artery. | 1405 | ||
| Subclavian Artery Occlusive Disease | 1406 | ||
| Subclavian Artery Bypass. | 1406 | ||
| Subclavian Artery Stenting. | 1406 | ||
| Multivessel Occlusive Disease | 1407 | ||
| Takayasu Arteritis | 1407 | ||
| Coronary-Subclavian Steal Syndrome | 1407 | ||
| Concurrent Carotid and Coronary Artery Atherosclerosis | 1408 | ||
| Overview | 1408 | ||
| Risk Factors for Stroke after Cardiac Surgery | 1408 | ||
| Surgical Approaches to Concurrent Carotid and Coronary Disease | 1409 | ||
| Synchronous Carotid Endarterectomy and Coronary Artery Bypass Grafting | 1409 | ||
| Staged Approach: Carotid Revascularization Followed by Coronary Artery Bypass Grafting | 1409 | ||
| Reverse Staged Approach: Coronary Artery Bypass Grafting Followed by Carotid Endarterectomy | 1410 | ||
| Carotid Artery Stenting Followed by Coronary Artery Bypass Grafting | 1410 | ||
| Synchronous Off-Pump Coronary Artery Bypass Grafting and Carotid Endarterectomy | 1411 | ||
| Summary | 1411 | ||
| Acknowledgments | 1412 | ||
| References | 1412 | ||
| 74 Percutaneous Intervention on Abdominal Aortic and Peripheral Vascular Disease | 1415 | ||
| Chapter Outline | 1415 | ||
| Peripheral Angiography | 1415 | ||
| Indications | 1415 | ||
| Contraindications | 1416 | ||
| Complications | 1416 | ||
| General Considerations | 1417 | ||
| Specific Anatomic Imaging | 1417 | ||
| Thoracic Aorta | 1417 | ||
| Abdominal Aorta | 1417 | ||
| Head and Neck Angiography | 1418 | ||
| Renal Vascular Imaging | 1419 | ||
| Lower Extremity Angiography | 1419 | ||
| Iliac Vessels | 1419 | ||
| Angiographic Technique | 1420 | ||
| Infrainguinal Vessels | 1421 | ||
| Percutaneous Intervention | 1421 | ||
| Thoracic and Abdominal Aorta | 1421 | ||
| Head and Neck Vessels | 1422 | ||
| Renal Arteries | 1423 | ||
| Lower Extremity | 1424 | ||
| Iliac Vessels | 1424 | ||
| Infrainguinal Vessels | 1425 | ||
| References | 1426 | ||
| 75 Injury to the Heart and Great Vessels | 1429 | ||
| Chapter Outline | 1429 | ||
| Blunt Cardiac Injury | 1429 | ||
| Historical Perspective | 1429 | ||
| Mechanism, Pathophysiology, and Incidence | 1430 | ||
| Clinical Presentation | 1430 | ||
| Diagnosis | 1430 | ||
| Electrocardiography | 1430 | ||
| Cardiac Enzymes and Troponins | 1430 | ||
| Two-Dimensional Transthoracic and Transesophageal Echocardiography | 1430 | ||
| Radionuclide Scans | 1430 | ||
| Spectrum of Blunt Cardiac Injury: Assessment and Management | 1430 | ||
| Pericardial Injury | 1430 | ||
| Valvular, Papillary Muscle, Chordae Tendinea, and Septal Injury | 1431 | ||
| Blunt Coronary Artery Injury | 1431 | ||
| Cardiac Chamber Rupture | 1431 | ||
| Myocardial Contusion | 1431 | ||
| Conclusion | 1431 | ||
| Penetrating Cardiac Injury | 1431 | ||
| Historical Perspective | 1431 | ||
| Incidence | 1432 | ||
| Etiology | 1432 | ||
| Clinical Presentation | 1432 | ||
| Diagnosis | 1432 | ||
| Subxyphoid Pericardial Window | 1432 | ||
| Two-Dimensional Echocardiography | 1432 | ||
| Management | 1432 | ||
| Techniques for Cardiac Injury Repair | 1433 | ||
| Incisions | 1433 | ||
| Adjunct Maneuvers | 1433 | ||
| Repair of Atrial Injuries | 1433 | ||
| Repair of Ventricular Injuries | 1433 | ||
| Coronary Artery Injuries | 1433 | ||
| Complex and Combined Injuries | 1433 | ||
| Conclusion | 1433 | ||
| Thoracic Aorta and Arch Vessel Injuries | 1433 | ||
| Mechanisms and Types of Injury | 1433 | ||
| Natural History | 1434 | ||
| Diagnosis | 1434 | ||
| Assessment and Management | 1434 | ||
| Ascending Aorta and Arch Vessel Injuries | 1434 | ||
| Descending Thoracic Aortic Injuries | 1435 | ||
| Innominate and Arch Vessel Injuries | 1435 | ||
| Conclusion | 1435 | ||
| References | 1435 | ||
| F Surgical Management of Valvular Heart Disease | 1438 | ||
| 76 Valve Replacement Therapy: | 1439 | ||
| Chapter Outline | 1439 | ||
| The Ideal Valve | 1439 | ||
| History | 1439 | ||
| Morbidity and Mortality Guidelines for Valve Operations | 1440 | ||
| Prosthetic Heart Valves | 1441 | ||
| Mechanical Valves | 1441 | ||
| Bileaflet Prostheses | 1441 | ||
| Medtronic. | 1441 | ||
| St. Jude Medical. | 1443 | ||
| Sorin Group. | 1444 | ||
| On-X Life Technologies. | 1445 | ||
| Bioprosthetic Valves | 1445 | ||
| Stented Porcine Bioprostheses | 1445 | ||
| Medtronic. | 1445 | ||
| Edwards Lifesciences. | 1446 | ||
| St. Jude Medical. | 1447 | ||
| Stented Bovine Pericardial Bioprostheses | 1447 | ||
| Edwards Lifesciences. | 1447 | ||
| Sorin Group. | 1448 | ||
| St. Jude Medical. | 1449 | ||
| Stentless Bioprostheses | 1449 | ||
| Medtronic. | 1449 | ||
| Sorin Group. | 1450 | ||
| Edwards Lifesciences. | 1450 | ||
| Sutureless Valves | 1450 | ||
| Medtronic. | 1450 | ||
| Sorin Group. | 1451 | ||
| Edwards Lifesciences. | 1451 | ||
| Transcatheter Valves | 1452 | ||
| Homograft Valve Replacement | 1452 | ||
| Choice of Valve Replacement | 1452 | ||
| References | 1453 | ||
| 77 Surgical Treatment of Aortic Valve Disease | 1456 | ||
| Chapter Outline | 1456 | ||
| Functional Anatomy of the Aortic Valve | 1456 | ||
| Aortic Stenosis | 1456 | ||
| Epidemiology and Etiology | 1456 | ||
| Pathophysiology | 1456 | ||
| Clinical Features | 1457 | ||
| Diagnosis and Grading | 1457 | ||
| Natural History | 1457 | ||
| Indications for Surgery | 1457 | ||
| Aortic Regurgitation | 1458 | ||
| Aortic Valve Replacement | 1458 | ||
| Operative Techniques | 1458 | ||
| Aortic Root Enlargement | 1462 | ||
| Nicks-Nunez Technique | 1462 | ||
| Rittenhouse-Manouguian Technique | 1464 | ||
| Konno-Rastan Technique | 1464 | ||
| Special Considerations of Postoperative Care | 1465 | ||
| Outcomes | 1465 | ||
| Early Mortality | 1465 | ||
| Long-Term Survival | 1466 | ||
| Early Complications | 1466 | ||
| Neurologic Complications | 1466 | ||
| Heart Block and Permanent Pacemaker Implantation | 1466 | ||
| Late Complications | 1466 | ||
| Thromboembolism, Anticoagulation, and Bleeding Complications | 1466 | ||
| Prosthetic Valve Endocarditis | 1467 | ||
| Structural Valve Deterioration and Freedom from Reoperation | 1467 | ||
| Paravalvular Leak and Hemolysis | 1468 | ||
| Symptomatic Relief | 1468 | ||
| Left Ventricular Remodeling | 1468 | ||
| Prosthesis-Patient Mismatch | 1468 | ||
| References | 1468 | ||
| 78 Aortic Valve Repair | 1472 | ||
| Chapter Outline | 1472 | ||
| Aortic Regurgitation | 1472 | ||
| Epidemiology and Etiology | 1472 | ||
| Pathophysiology | 1472 | ||
| Clinical Features | 1473 | ||
| Diagnostic Criteria | 1473 | ||
| Indications for Surgery | 1473 | ||
| Aortic Valve Anatomy and Function | 1473 | ||
| Classification of Aortic Insufficiency | 1474 | ||
| Surgical Techniques | 1475 | ||
| Exposure and Assessment | 1475 | ||
| Interventions on the Aortic Root and Annulus | 1475 | ||
| Subcommissural Annuloplasty | 1476 | ||
| Valve-Sparing Root Replacement: Reimplantation Technique | 1477 | ||
| Aortic Root Preparation. | 1477 | ||
| Prosthesis Sizing. | 1477 | ||
| Proximal Suture Line. | 1478 | ||
| Prosthesis Preparation and Fixation. | 1479 | ||
| Valve Reimplantation. | 1479 | ||
| Leaflet Assessment and Repair. | 1479 | ||
| Alternative Approaches to Aortic Valve Annuloplasty | 1479 | ||
| Cusp Repair Techniques | 1479 | ||
| Free Margin Plication | 1479 | ||
| Free Margin Resuspension | 1480 | ||
| Cusp Shaving, Resection, and Patch Use | 1480 | ||
| Bicuspid Aortic Valve Repair | 1481 | ||
| Unicuspid and Quadricuspid Aortic Valves | 1483 | ||
| Intraoperative Echocardiography | 1484 | ||
| Outcomes | 1485 | ||
| Overall | 1485 | ||
| Valve-Sparing Aortic Replacement | 1486 | ||
| Bicuspid Aortic Valve Repair | 1487 | ||
| Trileaflet Aortic Valve Repair | 1487 | ||
| Valve-Related Complications | 1488 | ||
| Conclusion | 1488 | ||
| References | 1488 | ||
| 79 Transcatheter Aortic Valve Replacement | 1490 | ||
| Chapter Outline | 1490 | ||
| Introduction | 1490 | ||
| Indications | 1490 | ||
| Preoperative Evaluation and Planning | 1491 | ||
| Aortic Valve Assessment | 1491 | ||
| Lower Extremity Assessment | 1492 | ||
| Other Comorbidity Assessment | 1492 | ||
| Alternative Access Considerations | 1492 | ||
| Operative Techniques | 1493 | ||
| Transfemoral TAVR | 1493 | ||
| Transapical TAVR | 1495 | ||
| Transaortic TAVR | 1495 | ||
| Subclavian TAVR | 1496 | ||
| Transcarotid TAVR | 1496 | ||
| Results | 1497 | ||
| SAPIEN Valve | 1497 | ||
| CoreValve | 1498 | ||
| TAVR in Patients with Prior SAVR | 1499 | ||
| Specific Patient Comorbidities | 1499 | ||
| Gender | 1499 | ||
| Diabetes Mellitus | 1499 | ||
| Mitral Regurgitation | 1500 | ||
| Renal Dysfunction | 1500 | ||
| Complications | 1500 | ||
| Acute Hypotension | 1500 | ||
| Stroke | 1500 | ||
| Acute Kidney Disease | 1501 | ||
| Vascular Complications | 1501 | ||
| Aortic Insufficiency | 1502 | ||
| Valve Embolization | 1502 | ||
| Coronary Occlusion | 1503 | ||
| Conduction Abnormalities | 1503 | ||
| Uncommon Complications | 1503 | ||
| Future Directions | 1503 | ||
| References | 1504 | ||
| 80 Surgical Treatment of the Mitral Valve | 1506 | ||
| Chapter Outline | 1506 | ||
| Anatomy | 1507 | ||
| Annulus | 1507 | ||
| Leaflets | 1507 | ||
| Chordae Tendineae | 1507 | ||
| Papillary Muscles and Left Ventricular Wall | 1508 | ||
| Mitral Stenosis | 1508 | ||
| Pathophysiology | 1508 | ||
| Etiology | 1509 | ||
| Clinical Characteristics and Diagnosis | 1509 | ||
| Natural History | 1510 | ||
| Indications for Surgery | 1511 | ||
| Mitral Regurgitation | 1511 | ||
| Pathophysiology | 1511 | ||
| Functional Classification | 1513 | ||
| Etiology | 1514 | ||
| Degenerative Disease | 1514 | ||
| Rheumatic Disease | 1515 | ||
| Mitral Annular Calcification | 1515 | ||
| Infective Endocarditis | 1515 | ||
| Ischemic Cardiomyopathy | 1517 | ||
| Dilated Cardiomyopathy and Submitral Left Ventricular Aneurysms | 1517 | ||
| Clinical Characteristics and Diagnosis | 1517 | ||
| Chronic | 1517 | ||
| Acute | 1517 | ||
| Natural History | 1517 | ||
| Degenerative Disease | 1518 | ||
| Ischemic Cardiomyopathy | 1519 | ||
| Rheumatic Disease | 1519 | ||
| Infective Endocarditis | 1519 | ||
| Indications for Surgery | 1519 | ||
| Symptoms | 1519 | ||
| Left Ventricular Dysfunction and Enlargement | 1519 | ||
| Atrial Fibrillation and Pulmonary Hypertension | 1519 | ||
| Reparability | 1521 | ||
| Surgery | 1521 | ||
| Anesthesia and Monitoring | 1521 | ||
| Surgical Approaches | 1522 | ||
| Median Sternotomy | 1522 | ||
| Minimally Invasive Approaches | 1522 | ||
| Myocardial Management | 1523 | ||
| Operative Sequence in Context of Concomitant Procedures | 1523 | ||
| Exposure of the Mitral Valve | 1523 | ||
| Interatrial Approach through Sondergaard’s Groove | 1523 | ||
| Right Atrial Trans-septal Approach | 1524 | ||
| Left Atrial Dome Approach | 1524 | ||
| Open Commissurotomy | 1524 | ||
| Mitral Valve Repair | 1525 | ||
| Fundamentals of Reconstructive Surgery | 1525 | ||
| Valve Analysis. | 1525 | ||
| Remodeling Ring Annuloplasty. | 1525 | ||
| Assessment of Repair. | 1526 | ||
| Valve Repair in Type I Dysfunction | 1526 | ||
| Valve Repair in Type II Dysfunction | 1526 | ||
| Posterior Leaflet Prolapse. | 1526 | ||
| Quadrangular Resection with or without Sliding Plasty and Triangular Resection. | 1526 | ||
| Posterior Ventricular Anchoring Neochordal Remodeling Repair. | 1526 | ||
| Anterior Leaflet Prolapse. | 1528 | ||
| Triangular Resection. | 1528 | ||
| Chordal Transposition. | 1528 | ||
| Artificial Neochordae. | 1528 | ||
| Double Orifice Edge-to-Edge Repair. | 1529 | ||
| Commissural Prolapse. | 1529 | ||
| Valve Repair in Type IIIa Dysfunction | 1529 | ||
| Valve Repair in Type IIIb Dysfunction | 1530 | ||
| Annular Decalcification and Annular Reconstruction | 1531 | ||
| Considerations in Endocarditis | 1531 | ||
| Systolic Anterior Motion of the Anterior Leaflet | 1532 | ||
| Mitral Valve Replacement | 1532 | ||
| Prosthesis Orientation | 1534 | ||
| Prosthesis Selection | 1534 | ||
| Results | 1534 | ||
| Commissurotomy for Mitral Stenosis | 1535 | ||
| Early Mortality and Late Survival | 1535 | ||
| Functional Status | 1535 | ||
| Mitral Regurgitation after Commissurotomy | 1535 | ||
| Reintervention | 1536 | ||
| Valve Repair for Mitral Regurgitation | 1536 | ||
| Early Mortality and Late Survival | 1536 | ||
| Functional Status | 1537 | ||
| Left Ventricular Dysfunction and Remodeling | 1537 | ||
| Residual and Recurrent Mitral Regurgitation | 1537 | ||
| Thromboembolic Events | 1538 | ||
| Systolic Anterior Motion of the Anterior Leaflet | 1538 | ||
| Infective Endocarditis | 1538 | ||
| Reoperation | 1538 | ||
| Mitral Valve Replacement | 1539 | ||
| Early Mortality and Late Survival | 1539 | ||
| Functional Status | 1540 | ||
| Left Ventricular Dysfunction and Remodeling | 1540 | ||
| Thromboembolic Events | 1540 | ||
| Acute Valve Thrombosis | 1540 | ||
| Hemorrhagic Events from Anticoagulation | 1540 | ||
| Structural Valve Degeneration | 1540 | ||
| Periprosthetic Leakage | 1541 | ||
| Prosthetic Valve Endocarditis | 1542 | ||
| Reoperation | 1542 | ||
| Minimally Invasive Mitral Valve Surgery | 1542 | ||
| Early Mortality and Late Survival | 1542 | ||
| Residual and Recurrent Mitral Regurgitation | 1542 | ||
| Postoperative Bleeding and Transfusion | 1542 | ||
| Pulmonary Function | 1543 | ||
| Length of Stay | 1543 | ||
| Postoperative Pain and Cosmetic Benefits | 1543 | ||
| Cost | 1543 | ||
| Robotic Technology | 1544 | ||
| Risks | 1544 | ||
| Learning Curve | 1544 | ||
| Percutaneous Technology | 1544 | ||
| References | 1545 | ||
| 81 Surgical Treatment of Tricuspid Valve Diseases | 1552 | ||
| Chapter Outline | 1552 | ||
| Surgical Anatomy | 1552 | ||
| Tricuspid Valve Annulus | 1553 | ||
| Leaflets | 1553 | ||
| Chordae Tendineae and Papillary Muscles | 1554 | ||
| Terminology | 1555 | ||
| Anatomic Relationships | 1555 | ||
| Pathophysiology | 1555 | ||
| Organic Tricuspid Valve Disease | 1556 | ||
| Functional Tricuspid Regurgitation | 1556 | ||
| Diagnosis | 1557 | ||
| Indications for Surgery | 1558 | ||
| Can Tricuspid Valve Disease Be Ignored? | 1559 | ||
| Specific Surgical Indications | 1560 | ||
| Tricuspid Valve Disease Associated with Left-Sided Valvular Lesions | 1560 | ||
| Organic Lesions | 1560 | ||
| Traumatic Insufficiencies | 1560 | ||
| Infective Endocarditis | 1560 | ||
| Functional Tricuspid Regurgitation | 1560 | ||
| Functional Tricuspid Regurgitation after Heart Transplantation | 1560 | ||
| Congestive Heart Failure Secondary to Ischemic or Idiopathic Cardiomyopathy with Mitral Valve Regurgitation | 1560 | ||
| Tricuspid Valve Surgery | 1561 | ||
| Surgical Approaches to the Tricuspid Valve | 1561 | ||
| Tricuspid Valve Commissurotomy | 1561 | ||
| Repair Maneuvers | 1562 | ||
| Tricuspid Valve Annuloplasty | 1563 | ||
| Tricuspid Valve Replacement | 1565 | ||
| Results | 1566 | ||
| Annuloplasty | 1566 | ||
| Tricuspid Valve Replacement | 1566 | ||
| Knowledge and Evidence | 1568 | ||
| Knowledge | 1568 | ||
| Evidence | 1569 | ||
| The Future | 1569 | ||
| Imaging | 1569 | ||
| Newer Technologies, Newer Devices, Newer Philosophies | 1570 | ||
| Rings | 1570 | ||
| Three-Dimensional Rings | 1570 | ||
| Biodegradable Annuloplasty | 1570 | ||
| Valves and Techniques | 1571 | ||
| The Controversy: Prophylaxis? | 1572 | ||
| The Research | 1572 | ||
| References | 1572 | ||
| 82 Native and Prosthetic Valve Endocarditis | 1579 | ||
| Chapter Outline | 1579 | ||
| Native Valve Endocarditis | 1579 | ||
| Pathology | 1579 | ||
| Microbiology | 1580 | ||
| Diagnosis | 1580 | ||
| Clinical Presentation | 1580 | ||
| Imaging Studies | 1580 | ||
| Duke Criteria | 1580 | ||
| Management | 1580 | ||
| Surgical Considerations | 1582 | ||
| Native Aortic Valve Endocarditis | 1582 | ||
| Native Mitral Valve Endocarditis | 1582 | ||
| Native Tricuspid Valve Endocarditis | 1583 | ||
| Results | 1584 | ||
| Prosthetic Valve Endocarditis | 1584 | ||
| Summary | 1585 | ||
| References | 1585 | ||
| 83 Anticoagulation, Thrombosis, and Thromboembolism of Prosthetic Cardiac Valves | 1588 | ||
| Chapter Outline | 1588 | ||
| Artificial Surfaces, Coagulation Cascades, Thrombosis, and Lysis | 1588 | ||
| Anticoagulation Therapy | 1589 | ||
| Complications of Anticoagulation | 1590 | ||
| Warfarin Sodium | 1590 | ||
| Heparin Sulfate System | 1592 | ||
| Direct Thrombin Inhibitors and Factor Xa Inhibitors | 1592 | ||
| Antiplatelet Agents | 1592 | ||
| Prosthetic Heart Valves | 1592 | ||
| Prosthetic and Mechanical Heart Valves and Thromboembolism | 1593 | ||
| Bioprosthetic Valves and Thromboembolism | 1593 | ||
| Management of Prosthetic Valve Thrombosis | 1594 | ||
| References | 1595 | ||
| 84 Robotic and Minimally Invasive Mitral Valve Surgery | 1597 | ||
| Chapter Outline | 1597 | ||
| Robotic Systems | 1597 | ||
| Evolution of Robotic Cardiac Surgery | 1598 | ||
| Clinical Applications and Patient Selection | 1598 | ||
| Surgical Techniques | 1599 | ||
| Clinical Outcomes | 1600 | ||
| Limitations | 1601 | ||
| Other Minimally Invasive Approaches | 1602 | ||
| Future Systems and Novel Visualization Techniques | 1602 | ||
| Conclusion | 1603 | ||
| References | 1603 | ||
| G Management of Cardiac Arrhythmias | 1605 | ||
| 85 Cardiac Devices for the Treatment of Bradyarrhythmias and Tachyarrhythmias | 1606 | ||
| Chapter Outline | 1606 | ||
| Historical Perspective and Overview | 1607 | ||
| Indications for Implantation of Cardiac Devices | 1607 | ||
| Temporary Pacemakers | 1607 | ||
| Indications | 1607 | ||
| Venous Access | 1607 | ||
| Permanent Pacemakers | 1608 | ||
| Indications | 1608 | ||
| Cardiac Resynchronization Therapy (or Biventricular Pacing) for the Treatment of Congestive Heart Failure | 1613 | ||
| Contraindications | 1614 | ||
| Implantable Cardioverter-Defibrillators | 1614 | ||
| Indications | 1614 | ||
| Contraindications to Implantable Cardioverter-Defibrillator Therapy | 1614 | ||
| Basic Concepts of Pacing and Antitachycardia Therapy | 1616 | ||
| Permanent Pacemakers | 1616 | ||
| Pulse Generator | 1616 | ||
| Pacemaker Leads | 1616 | ||
| Pacing | 1617 | ||
| Sensing | 1617 | ||
| Basic Pacing Modes | 1618 | ||
| Implantable Cardioverter-Defibrillators | 1618 | ||
| Pulse Generator | 1619 | ||
| Leads | 1619 | ||
| Tachyarrhythmia Detection | 1619 | ||
| Tachyarrhythmia Therapy | 1620 | ||
| High-Energy Defibrillation. | 1620 | ||
| Low-Energy Synchronized Cardioversions. | 1620 | ||
| Antitachycardia Pacing. | 1620 | ||
| Preoperative Evaluation Before Implantation of Cardiac Devices | 1620 | ||
| Clinical Considerations | 1620 | ||
| Standard Transvenous Techniques for Implantation of Cardiac Devices | 1621 | ||
| Temporary Transvenous Pacemakers | 1621 | ||
| Permanent Pacemakers | 1622 | ||
| Cephalic Vein (Cutdown) Approach | 1622 | ||
| Axillary Vein Approach | 1622 | ||
| Subclavian Vein Approach | 1622 | ||
| Technique | 1622 | ||
| Implantable Cardioverter-Defibrillators | 1623 | ||
| Defibrillation Threshold Testing | 1624 | ||
| Postimplantation Care of Transvenous Cardiac Devices | 1624 | ||
| Complications of Implantable Cardiac Devices | 1625 | ||
| Extraction of Chronic Leads Used in Transvenous Cardiac Devices | 1625 | ||
| Overview | 1625 | ||
| Tools Used in Chronic Lead Transvenous Extractions | 1627 | ||
| Angiographic Catheters, Snares, Forceps, and Locking Stylets | 1627 | ||
| Byrd Dilator Sheaths | 1627 | ||
| Excimer Laser Sheaths | 1627 | ||
| Electrosurgical Dissection Systems | 1627 | ||
| Techniques of Chronic Lead Transvenous Extractions | 1627 | ||
| Extraction through the Implant Vein | 1627 | ||
| Extraction through the Femoral Vein | 1628 | ||
| Complications | 1628 | ||
| Management of Cardiac Devices During and After Surgery | 1628 | ||
| Pacemakers | 1628 | ||
| Implantable Cardioverter-Defibrillators | 1628 | ||
| References | 1629 | ||
| 86 Catheter Ablation of Arrhythmias | 1631 | ||
| Chapter Outline | 1631 | ||
| Procedural Technique and the Electrophysiology Study | 1631 | ||
| Cardiac Mapping Techniques | 1632 | ||
| Catheter Ablation | 1633 | ||
| Specific Arrhythmias | 1634 | ||
| Atrioventricular Nodal Reentrant Tachycardia | 1634 | ||
| Atrial Tachycardia | 1635 | ||
| Atrial Flutter | 1636 | ||
| Accessory Pathway–Mediated Tachycardia | 1637 | ||
| Reentrant Ventricular Tachycardia and Structural Heart Disease | 1638 | ||
| Idiopathic Ventricular Tachycardia | 1641 | ||
| Atrial Fibrillation | 1641 | ||
| Atrioventricular Junction Ablation | 1641 | ||
| Catheter Ablation of Atrial Fibrillation | 1642 | ||
| Cryoballoon Ablation of Atrial Fibrillation | 1644 | ||
| References | 1644 | ||
| 87 Surgical Treatment of Cardiac Arrhythmias | 1648 | ||
| Chapter Outline | 1648 | ||
| Atrial Fibrillation | 1648 | ||
| Background | 1648 | ||
| Classification of Atrial Fibrillation | 1649 | ||
| Electrophysiology of Atrial Fibrillation | 1649 | ||
| Medical Treatment | 1650 | ||
| Historical Aspects of Surgery for Atrial Fibrillation | 1650 | ||
| Left Atrial Isolation Procedure. | 1650 | ||
| Catheter Ablation of the Atrioventricular Node–His Bundle Complex. | 1651 | ||
| Corridor Procedure. | 1651 | ||
| Atrial Transection Procedure. | 1651 | ||
| Development of the Cox-Maze Procedure | 1651 | ||
| Surgical Ablation Technology | 1651 | ||
| Radiofrequency Energy | 1653 | ||
| Cryoablation | 1654 | ||
| Surgical Indications for Treatment of Atrial Fibrillation | 1654 | ||
| Surgical Technique: Cox-Maze Procedure | 1654 | ||
| Pulmonary Vein Isolation | 1655 | ||
| Right Atrial Lesion Set | 1655 | ||
| Left Atrial Lesion Set | 1656 | ||
| Surgical Results: Cox-Maze Procedure | 1657 | ||
| Surgical Technique: Other Atrial Fibrillation Procedures | 1658 | ||
| Surgical Results: Other Atrial Fibrillation Procedures | 1660 | ||
| Future Surgical Treatments for Atrial Fibrillation | 1661 | ||
| Conclusions | 1661 | ||
| Inappropriate Sinus Tachycardia | 1662 | ||
| Background and Indications | 1662 | ||
| Surgical Technique: Superior Right Atrial Isolation | 1662 | ||
| Surgical Results | 1662 | ||
| Conclusions | 1663 | ||
| Ventricular Tachycardia | 1663 | ||
| Background | 1663 | ||
| Historical Aspects of Surgery for Ventricular Tachycardia | 1663 | ||
| Surgical Indications for Ventricular Tachycardia | 1664 | ||
| Surgical Techniques for Ventricular Tachycardia | 1664 | ||
| Revascularization | 1664 | ||
| Endocardial Resection | 1665 | ||
| Left Ventricular Reconstruction | 1665 | ||
| Cardiac Assist Devices and Heart Transplantation | 1666 | ||
| Conclusions | 1666 | ||
| References | 1666 | ||
| H Surgical Management of Coronary Artery Disease and Its Complications | 1672 | ||
| 88 Coronary Artery Bypass Grafting | 1673 | ||
| Chapter Outline | 1673 | ||
| Background | 1674 | ||
| History | 1674 | ||
| Anatomic Considerations | 1675 | ||
| Indications for Operation | 1675 | ||
| Clinical Scenarios and CABG Indications | 1676 | ||
| Stable Ischemic Heart Disease | 1676 | ||
| Acute Coronary Syndromes | 1676 | ||
| Unstable Angina/Non–ST-Segment Elevation Myocardial Infarction. | 1676 | ||
| ST-Segment Elevation (Q Wave) Myocardial Infarction. | 1676 | ||
| Spontaneous Coronary Artery Dissection. | 1678 | ||
| Concomitant Noncoronary Cardiac Surgery | 1678 | ||
| Left Ventricular Dysfunction and Heart Failure | 1678 | ||
| Life-Threatening Ventricular Arrhythmias and Sudden Cardiac Death | 1678 | ||
| Failed Percutaneous Coronary Intervention | 1678 | ||
| Previous Coronary Artery Bypass Grafting | 1679 | ||
| Surgical Technique | 1679 | ||
| Preoperative Preparation | 1679 | ||
| History and Physical Examination | 1679 | ||
| Medications | 1680 | ||
| Laboratory Tests | 1680 | ||
| Coronary Angiogram | 1680 | ||
| Conduit Selection | 1681 | ||
| Internal Thoracic Artery Grafts | 1681 | ||
| Radial Artery Grafts | 1682 | ||
| Gastroepiploic Artery Grafts | 1683 | ||
| Saphenous Vein Grafts | 1683 | ||
| Other Conduits | 1684 | ||
| Operative Preparation | 1684 | ||
| Cardiopulmonary Bypass and Cardioplegia | 1685 | ||
| Special Situations | 1685 | ||
| Diffuse Aortic Disease. | 1685 | ||
| Preoperative Cardiogenic Shock. | 1685 | ||
| Medication-Related Coagulation Impairment. | 1685 | ||
| Previous Tracheostomy. | 1686 | ||
| Distal Anastomoses | 1686 | ||
| Coronary Endarterectomy | 1687 | ||
| Sutureless Distal Coronary Connectors | 1688 | ||
| Proximal Anastomoses | 1688 | ||
| Sutureless Proximal Coronary Connectors | 1688 | ||
| Intraoperative Graft Assessment | 1688 | ||
| Weaning from Cardiopulmonary Bypass | 1689 | ||
| Special Features of Postoperative Care | 1690 | ||
| Early Postoperative Period | 1690 | ||
| Late Postoperative Period | 1690 | ||
| Results | 1691 | ||
| Morbidity | 1691 | ||
| Postoperative Bleeding and Transfusion | 1691 | ||
| Low Cardiac Output Syndrome | 1691 | ||
| Perioperative Myocardial Infarction | 1692 | ||
| Neurologic Events | 1692 | ||
| Postoperative Renal Dysfunction | 1692 | ||
| Atrial Fibrillation | 1693 | ||
| Sternal Wound Infections | 1693 | ||
| Mortality | 1693 | ||
| Freedom from Cardiac Events | 1694 | ||
| Left Ventricular Function | 1694 | ||
| Functional Status and Quality of Life | 1695 | ||
| Graft Patency | 1695 | ||
| Saphenous Vein Grafts | 1695 | ||
| Internal Thoracic Artery Grafts | 1696 | ||
| Radial Artery Grafts | 1696 | ||
| Gastroepiploic Artery Grafts | 1696 | ||
| CABG versus PCI | 1696 | ||
| Conclusion | 1699 | ||
| References | 1700 | ||
| 89 Off-Pump Coronary Artery Bypass Grafting and Transmyocardial Laser Revascularization | 1711 | ||
| Chapter Outline | 1711 | ||
| Cardiopulmonary Bypass | 1712 | ||
| Multivessel Off-Pump Coronary Artery Bypass | 1712 | ||
| Self-Retaining Coronary Stabilizers | 1712 | ||
| Preventing Hemodynamic Compromise during Multivessel OPCAB | 1713 | ||
| Left Ventricular Compromise | 1713 | ||
| Right Ventricular Compromise | 1713 | ||
| Myocardial Ischemia | 1714 | ||
| Exposure Techniques | 1714 | ||
| Deep Pericardial Sutures | 1714 | ||
| Right Pleurotomy and Right Vertical Pericardiotomy | 1715 | ||
| Right Hemisternal Elevation | 1715 | ||
| Apical Suction Devices | 1716 | ||
| Results after OPCAB | 1717 | ||
| Minimizing Aortic Manipulation | 1718 | ||
| Neurocognitive Dysfunction after OPCAB | 1718 | ||
| Limited-Access Coronary Artery Bypass | 1719 | ||
| Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) | 1719 | ||
| Hybrid MIDCAB Approach | 1720 | ||
| Completely Endoscopic Robotic-Assisted CABG | 1720 | ||
| Port-Access CABG | 1721 | ||
| Transmyocardial Laser Revascularization | 1721 | ||
| Operative Procedure | 1721 | ||
| Clinical Results | 1721 | ||
| Mechanism | 1722 | ||
| Conclusion | 1722 | ||
| References | 1722 | ||
| 90 Robotic and Alternative Approaches to Coronary Artery Bypass Grafting | 1725 | ||
| Chapter Outline | 1725 | ||
| Robotic and Alternative Approaches to Coronary Artery Bypass Grafting | 1725 | ||
| Minimally Invasive Surgical Coronary Revascularization | 1725 | ||
| Minimally Invasive Direct Coronary Bypass | 1726 | ||
| Preoperative Considerations | 1726 | ||
| Technical Details | 1726 |