Cardiac surgery has traditionally been performed through a complete median sternotomy, which provides generous operative exposure to all structures in and around the heart. With this approach, complex cardiovascular procedures can be performed safely and effectively. Reductions in incision size…
Artificial Surfaces, Coagulation Cascades, Thrombosis, and Lysis Intravascular placement of a foreign body with its nonendothelial surface activates the clotting mechanism, leading to thrombus formation. The exposure of blood to the synthetic surface leads rapidly to deposition of a fine…
Endocarditis of a patient's native heart valve is defined as native valve endocarditis (NVE), and endocarditis of a prosthetic device is termed prosthetic valve endocarditis (PVE). The incidence of NVE in developed countries is approximately 1.7 to 7.0 cases out…
The tricuspid valve is often ignored by cardiologists and surgeons because of its unique characteristics. It is frequently called “The Forgotten Valve,” and there still is scant information regarding the effects of tricuspid valve diseases on the prognosis of cardiac…
Anatomy The mitral valve apparatus is composed of the mitral annulus, leaflets, chordae tendineae, papillary muscles, and the left ventricular lateral wall ( Fig. 80-1 ). Chordae tendineae and papillary muscles comprise the subvalvular apparatus. Annulus The right fibrous trigone…
Introduction Aortic stenosis is the most frequent acquired valve disease in older adult patients; consequently, the number of patients requiring treatment increases as the population ages. Current U.S. Census predictions indicate that by 2050 the number of citizens 85 years…
Aortic valve replacement remains the gold standard for the treatment of severe aortic valve disease. However, valve repair is emerging as a feasible and attractive alternative to valve replacement in selected patients. Valve repair can reduce or eliminate the risks…
Functional Anatomy of the Aortic Valve The aortic valve is the last of four cardiac valves through which the blood is pumped before it goes to the rest of the body. It separates the left ventricular outflow tract from the…
The Ideal Valve Many acceptable substitutes exist today for the replacement of diseased human heart valves. The ideal valvular prosthesis as described by Harken remains the gold standard of cardiac surgery. According to Harken this valve would be durable, with…
The heart is a vital organ, with its arch vessels encased in the chest cavity and protected by the manubrium, sternum, and rib cage. Injury to this organ can come from blunt trauma, which includes blunt cardiac injury, more commonly…