Key Points 1. Reoperative cardiac surgery presents greater risk than first-time surgery because patients are usually older, have more comorbidity, and have more advanced cardiovascular disease. Also, resternotomy can be hazardous due to adhesions of cardiac structures to the sternum.…
Key Points 1. Mechanical circulatory support (MCS) for the failing heart has become a mainstay of the modern management of patients with both acute and chronic heart failure refractory to pharmacologic and other usual interventions. 2. Outcomes with MCS have…
Key Points 1. A hybrid operating room combines advanced imaging capabilities with a fully functioning operating suite. 2. Transcatheter aortic valve replacement (TAVR) is recommended for patients with severe symptomatic aortic stenosis who are inoperable or at high risk for…
Key Points 1. The incidence of thromboembolic disease is difficult to estimate because of the nonspecific nature of presenting symptoms and a lack of awareness of the disorder. 2. Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of a…
Key Points 1. Cardiac denervation is an unavoidable consequence of heart transplantation, and reinnervation is at best partial and incomplete. 2. Drugs acting directly on the heart are the drugs of choice for altering cardiac physiology after heart transplantation. 3.…
Key Points 1. Cardiac tumors are rare. In general, a cardiac mass is more likely a vegetation or a thrombus than a tumor. Secondary (metastatic) tumors are far more common than primary cardiac tumors. Among primary cardiac tumors, benign lesions…
Key Points 1. Diseases of the thoracic aorta can occasionally be managed with medical treatment and surveillance, whereas others require surgical intervention. Depending on the disease process, some surgeries may be performed electively, whereas others are truly emergency operations. 2.…
Key Points 1. Because of successes in treating congenital cardiac lesions, there are currently as many or more adults than children with congenital heart disease (CHD). 2. These patients may require cardiac surgical intervention for primary cardiac repair, repair following…
Key Points 1. Although various valvular lesions generate different physiologic changes, all valvular heart disease is characterized by abnormalities of ventricular loading. 2. The left ventricle normally compensates for increases in afterload by increases in preload. This increase in end-diastolic…
Key Points 1. Guideline updates emphasize the efficacy of surgical approaches to myocardial revascularization in patients with multivessel coronary artery disease. 2. Perioperative risk reduction includes careful consideration of all of the patient's relevant antihypertensive, antiplatelet, and antianginal medications. 3.…