CARDIAC SURGERY IN THE ADULT Cohn_FM.indd i 8/26/11 7:10:58 PM NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsi- bility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. 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To contact a representa- tive please e-mail us at [email protected]. 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. TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc. 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Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. 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. Cohn_FM.indd v 8/26/11 7:11:01 PM This page intentionally left blank 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 Cohn_FM.indd vii 8/26/11 7:11:01 PM 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 Cohn_FM.indd viii 8/26/11 7:11:02 PM 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 Cohn_FM.indd ix 8/26/11 7:11:02 PM