Definition This chapter describes the surgical aspects of aortic valve disease, excluding congenital aortic stenosis in infants and children (see Chapter 47 ) and aortic regurgitation with either ventricular septal defect (see Chapter 35 ) or sinus of Valsalva aneurysm…
Section I Mitral Valve Disease Definition This chapter describes surgical aspects of acquired mitral valve disease, excluding ischemic mitral regurgitation (see Chapter 10 ). Associated or secondary tricuspid valve disease is also considered (see Section II of this chapter and…
Definition Mitral regurgitation due to ischemic heart disease (ischemic mitral regurgitation) is mitral regurgitation caused by ischemic heart disease. This entity must not be confused with mitral regurgitation from other causes that coexist with ischemic heart disease. Historical Note Mitral…
Definition Postinfarction ventricular septal defect (VSD) is an opening in the ventricular septum resulting from rupture of acutely infarcted myocardium. Historical Note In 1847, Latham first described a postinfarction VSD at autopsy, but it was not until 1923 that Brunn…
Definition A postinfarction left ventricular (LV) aneurysm is a well-delineated transmural fibrous scar, virtually devoid of muscle, in which the characteristic fine trabecular pattern of the inner surface of the wall has been replaced by smooth fibrous tissue. In such…
Definition Stenotic atherosclerotic coronary artery disease (CAD) is narrowing of the coronary arteries caused by thickening and loss of elasticity of their walls (arteriosclerosis) that, when sufficiently severe, limits blood flow to the myocardium. Initially, the disease limits only coronary…
Section I Generating Knowledge from Information, Data, and Analyses Introducing the Chapter What It Is About Cardiac surgical procedures, particularly coronary artery bypass grafting (CABG), are the most quantitatively studied therapies in the history of medicine. These studies reveal a…
The primary determinants of a cardiac operation's success are events in the operating room (OR), but even patients who are seriously ill when they leave the OR can survive and have a good long-term result when postoperative care is appropriate…
Section I Anesthetic Consultation for Adult Cardiovascular Surgery The principal tasks of the anesthesiologist are to provide relief from pain for patients during operation and to provide optimal operative conditions for surgeons, both in the safest manner possible. To do…
To whatever extent possible, injury to the myocardium must be avoided during operations utilizing cardiopulmonary bypass (CPB). During these operations, alterations of myocardial blood flow and oxygen demand are often imposed that, unmodified, might injure cellular energetics and morphology. We…