Ebook: Reoperations in Cardiac Surgery

Nearly a century has passed since Rehn performed the first successful cardiac operation by closing a right ventricular stab wound in a gravely ill patient. Moreover, it has been more than fifty years since Gross successfully corrected the first congenital cardiac malformation in 1938 by suture ligation of a patent ductus arteriosus. The introduction of the Blalock operation for tetralogy of Fallot by Blalock in 1944 greatly advanced the management and prognosis of a critically ill group of cardiac patients, and the success of this procedure further stimulated the development of concepts and techniques for the surgical management of other severe congenital cardiac defects. Until the successful use of extracorporeal circulation by Gibbon in 1953, it was often necessary to perform cardiac operations which were palliative rather than curative procedures. With the advent of additional new and improved techniques, correction of many hitherto incurable cardiac disorders became possible and reoperation under these circumstances became frequent. Cardiac surgery is very fortunate in having two master surgeons, whose distinctive contributions and clinical proficiency are recognized worldwide, to edit this extraordinary and unique text. They have placed emphasis on a number of specific complications of primary cardiac procedures which lead to the necessity for reoperation. Problems associated with postoperative infections, thrombotic dis­ orders, stenoses of suture lines, deterioration of prosthetic materials and mechanical valves, rejection of transplanted organs and tissues, and a host of additional complications are described together with their appropriate surgical management.

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With the increase in the number of cardiac operations performed each year, the incidence of reoperations has also increased; and the need for guidance from experts in the field has grown. This monograph provides comprehensive, up-to-date information on reoperations in paediatric and adult cardiac surgery. It is an excellent manual for the young surgeon and an invaluable reference for the established surgeon. The main part of the book is devoted to surgical technique, with a complete description of technical details and more than 300 illustrations showing the heart from the surgeon's perspective. The section on congenital heart disease covers all the major diagnostic groups, and the section on acquired heart disease contains coronary and valve surgery, arrhythmias and thoracic and thoracoabdominal aneurysms. The general section deals with investigations, anaesthesia, surgical approaches, infection, pacemakers and retransplantation. The chapters are written by twenty-nine authorities from seven countries; together they present a unique compilation of international expertise for the cardiovascular surgeon.