Step 1 Preoperative Considerations ◆ Chronic thromboembolic pulmonary hypertension (CTEPH) is an increasingly recognized clinical entity. Pulmonary embolism (PE) is a common disease, with an annual incidence of about 100/100,000 in the United States. Many episodes of PE, however, are…
Donor Step 1 Surgical Anatomy and Exposure ◆ The potential donor is placed supine on the operating room table. The standard incision for the multiorgan donor is a midline sternotomy incision extended into a midline abdominal incision to expose the…
See Video 32.1 on ExpertConsult.com . ◆ Since the first implantation of a left ventricular assist device (LVAD) by Dr. Michael DeBakey in 1966, the search for durable short- and long-term mechanical support has resulted in a myriad of devices…
◆ Extracorporeal membrane oxygenation (ECMO) pertains to prolonged extracorporeal cardiopulmonary bypass using intrathoracic or extrathoracic vascular cannulation. The bypass circuit includes a distensible venous blood reservoir receiving deoxygenated blood from the patient passing through a nonocclusive centrifugal pump toward the…
◆ Amelioration of left ventricular (LV) remodeling is an appealing target for medical and surgical therapies for heart failure. Remodeling is a complex process that leads to maladaptive ventricular dilation, hypertrophy, and altered ventricular wall stress and may occur after…
Step 1 Surgical Anatomy ◆ Knowledge of the anatomy involved with hypertrophic cardiomyopathy (HCM) is paramount in understanding the pathophysiology that ultimately contributes to dynamic subaortic obstruction. ◆ HCM is defined as left ventricular (LV) hypertrophy in the absence of…
Atrial Fibrillation ◆ Atrial fibrillation (AF) is a supraventricular tachyarrhythmia that is projected to affect 12 million patients in the United States by 2050; prevalence is increased in older people and in patients with hypertension, heart failure, coronary artery disease…
Summary ◆ Thoracic endovascular aortic repair (TEVAR) has become an effective treatment for various descending thoracic aortic pathologic processes, including aortic aneurysm and dissection. Although long-term outcome data for this therapy are not available, the short-term and intermediate results have…
See Video 26.1 on ExpertConsult.com . Step 1 Surgical Anatomy ◆ Thoracoabdominal aortic aneurysms (TAAAs) are characterized by dilation of the aorta (to at least 1.5 times its normal diameter) at the diaphragmatic hiatus—the boundary that separates the descending thoracic…
Step 1 Surgical Anatomy ◆ Academic anatomists refer to the aortic arch as that part of the aorta that begins and ends with a line drawn in cross section across the aorta at a level corresponding to the lesser curve…