Greater than 95% of patients with myocardial ischemia will have underlying atherosclerotic coronary artery disease as the etiology, with the remaining 5% possessing a range of congenital and acquired lesions. Although these lesions are rare individually, clinicians will inevitably encounter…
Disruption of the ventricular septum after myocardial infarction is an infrequent event after a full-thickness myocardial infarction. The resulting clinical syndrome can range from an asymptomatic murmur to an extensive left-to-right intracardiac shunt with resulting heart failure and shock. The…
Significant advances have been made in the treatment of ischemic cardiomyopathy; however the presence of mitral regurgitation in this population continues to be a significant risk factor for mortality. This chapter addresses the current concepts regarding the pathophysiology, decision making,…
Reoperations present coronary surgeons with their greatest challenges. Patients undergoing reoperation for bypass grafting are different from those who undergo primary surgery. In addition to the risks of a repeated median sternotomy, their coronary artery and noncardiac atherosclerosis is more…
Robotic and Alternative Approaches to Coronary Artery Bypass Grafting The standard approach for coronary artery bypass grafting (CABG) is median sternotomy using cardiopulmonary bypass. However, less invasive approaches, including off-pump CABG and smaller access surgeries with or without robotic assistance,…
In 1967, Sabiston and colleagues reported the first clinically successful coronary artery bypass graft (CABG) operation. Other early pioneers include Favaloro, who is credited with popularizing the use of autogenous saphenous vein, and Kolesov, who performed the first mammary artery…
Coronary artery bypass grafting (CABG) is among the most important surgical procedures in the history of medicine. Arguably, no other operation has prolonged more lives, provided more symptom relief, and been more thoroughly investigated. CABG has been the most common…
Current nonpharmacologic treatments for cardiac arrhythmias include catheter ablation, implantation of pacemakers and cardioverter-defibrillator devices, and surgery. These modalities can be used to treat essentially all supraventricular and ventricular tachyarrhythmias. Although the indications for surgical intervention have narrowed, surgery remains…
Over the past 40 years, cardiac electrophysiology has progressed from an esoteric field dedicated to understanding arrhythmia mechanisms to an indispensable modality in the diagnosis and treatment of cardiac arrhythmias. Electrophysiology therapeutics first began with cardiac surgery for the treatment…
Historical Perspective and Overview Paul Zoll developed the first transcutaneous electronic pacemaker in 1952 for the treatment of life-threatening bradycardia. The first internal pacemaker was implanted in 1958 for the treatment of complete heart block and in the management of…