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دانلود کتاب Sabiston and Spencer Surgery of the Chest
دانلود کتاب جراحی سابری و اسپنسر سینه
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Sabiston and Spencer Surgery of the Chest
ویرایش: 10 نویسندگان: Frank W. Sellke, Pedro J. del Nido, Scott J. Swanson سری: ISBN (شابک) : 0323790240, 9780323790253 ناشر: Elsevier سال نشر: 2023 تعداد صفحات: 2682 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 512 مگابایت
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Cover Title Page Sabiston and Spencer Surgery of the Chest, 10th edition Copyright Dedication Contributors Preface Contents Video Contents 1 Anatomy of the Thorax THORACIC CAGE THORACIC INLET CERVICOAXILLARY CANAL DIAPHRAGM ANATOMY OF BREATHING BONY THORACIC CAGE STERNUM RIBS MUSCLES OF THE THORAX INTERCOSTAL MUSCLES SURFACE ANATOMY MEDIASTINUM SUPERIOR MEDIASTINUM ANTERIOR MEDIASTINUM POSTERIOR MEDIASTINUM TRACHEOBRONCHIAL TREE LUNGS AND PULMONARY VASCULATURE PULMONARY ARTERY BRANCHING RIGHT PULMONARY ARTERY LEFT PULMONARY ARTERY RIGHT UPPER LOBECTOMY RIGHT MIDDLE LOBECTOMY RIGHT LOWER LOBECTOMY LEFT UPPER LOBECTOMY LEFT LOWER LOBECTOMY BRONCHIAL VASCULATURE PULMONARY LYMPH NODES ESOPHAGUS VESSELS OF THE THORAX DESCENDING THORACIC AORTA AZYGOS VEIN THORACIC DUCT NERVES OF THE THORAX VAGUS AND RECURRENT LARYNGEAL NERVES THORACIC SYMPATHETIC CHAIN PHRENIC NERVES References SUGGESTED READING 2 Radiologic Imaging of Thoracic Abnormalities Benign Lesions of the Lung INTRODUCTION MORPHOLOGIC FEATURES THAT INDICATE BENIGNITY GROWTH AND STABILITY COMMON BENIGN LESIONS AND CONDITIONS THAT MIMIC LUNG NODULES CONCLUSION Computed Tomography of Emphysema for Lung Volume Reduction Treatment Planning INTRODUCTION LUNG VOLUME REDUCTION SURGERY GIANT BULLA AND BULLECTOMY BRONCHOSCOPIC LUNG VOLUME REDUCTION AND ENDOBRONCHIAL VALVES CONCLUSION Interstitial Lung Diseases INTRODUCTION TYPES OF INTERSTITIAL LUNG DISEASE INTERSTITIAL LUNG DISEASE MIMICKERS SURGICAL MANAGEMENT OF INTERSTITIAL LUNG DISEASE CONCLUSION Thoracic Infections INTRODUCTION LUNG ABSCESS BRONCHIECTASIS EMPYEMA BRONCHOPLEURAL FISTULA MEDIASTINITIS CONCLUSION Radiology of the Mediastinum INTRODUCTION ANTERIOR MEDIASTINUM MIDDLE MEDIASTINUM POSTERIOR MEDIASTINUM CONCLUSION Imaging for Esophageal Surgical Intervention INTRODUCTION IMAGING OF ESOPHAGEAL TRAUMA IMAGING OF MALIGNANT ESOPHAGEAL TUMORS TUMOR (T) LYMPH NODES (N) METASTATIC DISEASE (M) LOCATION IMAGING OF BENIGN ESOPHAGEAL TUMORS POSTOPERATIVE ESOPHAGEAL EVALUATION CONCLUSION Traumatic Cardiothoracic Injuries INTRODUCTION CHEST WALL TRAUMA TRAUMATIC PULMONARY INJURIES PLEURAL INJURIES TRACHEOBRONCHIAL INJURY CARDIAC TRAUMA TRAUMATIC AORTIC INJURY ESOPHAGEAL INJURIES DIAPHRAGMATIC RUPTURE CONCLUSION REFERENCES 3 Preoperative Evaluation of Patients Undergoing Thoracic Surgery Physiologic Effects of Thoracic Surgery Patient Population Undergoing Thoracic Surgery Common Complications after Thoracic Surgery Goals of the Preoperative Evaluation History and Physical Examination HISTORY PHYSICAL EXAMINATION LABORATORY STUDIES Imaging Studies Pulmonary Function Testing Prediction of Postoperative Lung Function Cardiac Assessment of Patients Under Consideration for Thoracic Surgical Procedures Assessment of Functional Capacity ARTERIAL BLOOD GAS MEASUREMENTS PULMONARY HEMODYNAMICS AGE PREOPERATIVE INTERVENTION Evaluation and Risk Stratification REFERENCES 4 Perioperative Care of the Thoracic Surgical Patient PREOPERATIVE EDUCATION AND COUNSELING NUTRITION PULMONARY CARE, PREHABILITATION, AND SMOKING CESSATION ALCOHOL AND ILLEGAL SUBSTANCE ABUSE ANEMIA MANAGEMENT CARDIAC OPTIMIZATION DIABETES/CARBOHYDRATE LOADING PROPHYLAXIS ATRIAL FIBRILLATION DEEP VENOUS THROMBOSIS STRESS ULCERATION AND GASTRITIS INFECTION ANTICOAGULATION MISCELLANEOUS RESOURCE ALLOCATION ANALGESIA INTRAOPERATIVE CARE ANTISEPSIS VENTILATION MONITORING BODY TEMPERATURE POSITIONING FLUID ADMINISTRATION DRAINAGE SPECIMEN MANAGEMENT POSTOPERATIVE CARE FLUID MANAGEMENT BLOOD ADMINISTRATION MEDICATIONS ANALGESIA NUTRITION RESPIRATORY THERAPY WOUND CARE MANAGEMENT OF DRAINAGE TUBES PHYSICAL THERAPY Complications after Lung Surgery Early Complications Respiratory Complications Atelectasis and Pneumonia Prolonged Air Leak Pulmonary Edema Acute Respiratory Distress Syndrome Cardiac Complications Myocardial Infarction Atrial Fibrillation Bleeding LATE COMPLICATIONS Pulmonary Complications Bronchopleural Fistula Bronchovascular Fistula Postpneumonectomy Syndrome Wound Infection and Empyema Post-Thoracotomy Pain COMPLICATIONS AFTER ESOPHAGEAL SURGERY Dysphagia Stricture Gas Bloat COMPLICATIONS AFTER ESOPHAGECTOMY Anastomotic Leak Conduit Ischemia Recurrent Laryngeal Nerve Damage Chylothorax Functional Problems Reflux MISCELLANEOUS DISCHARGE PLANNING REFERENCES 5 Endoscopic Diagnosis of Thoracic Disease PRINCIPLES OF ENDOSCOPIC DIAGNOSIS PREPROCEDURAL CONSIDERATIONS FOR DIAGNOSTIC ENDOSCOPY UPPER ENDOSCOPY INDICATIONS SEDATION AND CONDUCT OF FLEXIBLE UPPER ENDOSCOPY COMPLICATIONS TECHNOLOGIES FLEXIBLE UPPER ENDOSCOPY Confirmation—Identifying Abnormal Tissue Real-Time Imaging Chromoendoscopy. Virtual Chromoendoscopy. Autofluorescence Imaging. Working-Channel Adjuncts Optical Coherence Tomography and Volumetric Laser Endomicroscopy. Confocal Laser Endomicroscopy. Acquisition—Improving Quality of Tissue Biopsy Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection. Wide-Area Transepithelial Sampling With Computer-Assisted 3-Dimensional Analysis. ENDOSCOPIC ULTRASOUND RIGID ESOPHAGOSCOPY BRONCHOSCOPY INDICATIONS SEDATION AND CONDUCT OF BRONCHOSCOPY SEDATION FLEXIBLE BRONCHOSCOPY RIGID BRONCHOSCOPY COMPLICATIONS TECHNOLOGIES FLEXIBLE BRONCHOSCOPY Selection and Approach Virtual Bronchoscopic Navigation. Electromagnetic Navigation Bronchoscopy. Approach and Confirm Ultrathin Bronchoscopy. Robotic Bronchoscopy. Confirm Two-Dimensional and CT Fluoroscopy. Cone-Beam CT. Augmented Fluoroscopy. VC, OCT, AFI, and CLE. Radial Probe Endobronchial Ultrasound. Acquire Cryobiopsy. Transparenchymal Biopsy. CURVILINEAR-PROBE ENDOBRONCHIAL ULTRASOUND RIGID BRONCHOSCOPY CONCLUSION REFERENCES 6 Endoscopic Therapies for Thoracic Diseases PHOTODYNAMIC THERAPY DEFINITION AND MECHANISM OF ACTION TECHNIQUE CONTRAINDICATIONS ENDOBRONCHIAL NON–SMALL CELL LUNG CANCER PALLIATIVE INTENT CURATIVE INTENT ESOPHAGEAL CANCER PALLIATIVE INTENT CURATIVE INTENT HIGH-GRADE DYSPLASIA IN BARRETT ESOPHAGUS ABLATIVE TECHNOLOGIES RADIOFREQUENCY ABLATION LASER ABLATION OF ENDOLUMINAL TUMORS AIRWAY ESOPHAGUS CRYOTHERAPY BRACHYTHERAPY STENTS Expandable METALLIC STENTS SILICONE-BASED STENTS TECHNIQUE EXPANDABLE METAL STENTS Silicone-Based Stents INDICATIONS MALIGNANT ESOPHAGEAL STRICTURES ESOPHAGEAL PERFORATION AND BENIGN ESOPHAGEAL STRICTURES MALIGNANT AIRWAY STRICTURES BENIGN AIRWAY STRICTURES COMPARISON OF PALLIATIVE ENDOSCOPIC THERAPIES EVOLVING ENDOSCOPIC TREATMENT MODALITIES FOR BENIGN ESOPHAGEAL DISEASES ACHLASIA ZENKER’s DIVERTICULUM OPEN APPROACHES TO ZENKER DIVERTICULUM TRANSORAL ENDOSCOPIC STAPLING ZENKER PERORAL ENDOSCOPIC MYOTOMY GASTROESOPHAGEAL REFLUX RADIOFREQUENCY THERAPY TO THE LOWER ESOPHAGEAL SPHINCTER INJECTION OF BIOPOLYMERS AT THE GASTROESOPHAGEAL JUNCTION ENDOSCOPIC PLICATION OF THE GASTROESOPHAGEAL JUNCTION ESOPHYX ENDOCINCH NDO Plicator G-POEM LINX REFERENCES 7 Thoracic Trauma PRIMARY SURVEY SECONDARY SURVEY DIAGNOSTIC TESTS CHEST RADIOGRAPHY ULTRASONOGRAPHY ECHOCARDIOGRAPHY AND COMPUTED TOMOGRAPHY ANGIOGRAPHY EMERGENCY DEPARTMENT THORACOTOMY BLUNT TRAUMA CHEST WALL RIB FRACTURES FLAIL CHEST STERNAL FRACTURES CLAVICULAR FRACTURES SCAPULAR FRACTURES TRAUMATIC ASPHYXIA PULMONARY CONTUSION LARYNGEAL INJURIES TRACHEOBRONCHIAL INJURIES GREAT VESSELS BLUNT CARDIAC INJURIES DIAPHRAGM ESOPHAGUS PENETRATING TRAUMA STAB WOUNDS VERSUS FIREARM INJURIES CHEST WALL INJURY TRACHEAL AND BRONCHIAL PENETRATING INJURIES PULMONARY INJURIES AND HEMOTHORAX CARDIAC INJURIES AIR EMBOLISM AND BULLET EMBOLISM GREAT VESSELS DIAPHRAGMATIC INJURIES ESOPHAGEAL INJURIES BLAST INJURIES COMPLICATIONS OF THORACIC TRAUMA ACUTE LUNG INJURY AND RESPIRATORY DISTRESS SYNDROME PNEUMONIA PLEURAL SPACE PROBLEMS BRONCHOPLEURAL FISTULA GREAT VESSEL FISTULA REFERENCES 8 Tracheal Lesions HISTORICAL PERSPECTIVE ANATOMY TRACHEAL PATHOLOGY POSTINTUBATION INJURIES IDIOPATHIC LARYNGOTRACHEAL STENOSIS TRACHEOBRONCHOMALACIA TRACHEAL TUMORS CLINICAL PRESENTATION RADIOGRAPHIC IMAGING BRONCHOSCOPY ANESTHESIA TRACHEAL RESECTION LARYNGOTRACHEAL RESECTION RELEASE PROCEDURES REPAIR OF TRACHEOINNOMINATE AND TRACHEOESOPHAGEAL FISTULAS AIRWAY REPLACEMENT PERIOPERATIVE MANAGEMENT RESULTS COMPLICATIONS SUMMARY REFERENCES 9 Congenital Pulmonary Diseases INTRODUCTION HISTORICAL PERSPECTIVES EMBRYOLOGY TRACHEAL ABNORMALITIES TRACHEAL AGENESIS AND ATRESIA CONGENITAL TRACHEAL STENOSIS TRACHEOMALACIA BRONCHIAL BRANCHING ABNORMALITIES BRONCHIAL ATRESIA CONGENITAL BRONCHIECTASIS TRACHEOBRONCHOMEGALY (MOUNIER-KUHN SYNDROME) LARYNGOTRACHEOESOPHAGEAL CLEFT TRACHEOBRONCHIAL-ESOPHAGEAL FISTULA BRONCHOBILIARY FISTULA BRONCHOPULMONARY FOREGUT MALFORMATIONS SEQUESTRATIONS AZYGOS LOBE HORSESHOE LUNG BRONCHOGENIC CYSTS LUNG BUD ANOMALIES PULMONARY AGENESIS, APLASIA, AND HYPOPLASIA CONGENITAL LOBAR EMPHYSEMA CONGENITAL PARENCHYMAL CYSTS CONGENITAL CYSTIC ADENOMATOID MALFORMATION INFANTILE PULMONARY EMPHYSEMA POLYALVEOLAR LOBE PULMONARY LYMPHANGIECTASIA VASCULAR ABNORMALITIES UNILATERAL ABSENCE OF A MAIN PULMONARY ARTERY IDIOPATHIC HYPERLUCENT LUNG SYNDROME (SWYER-JAMES OR MACLEOD SYNDROME) PULMONARY ARTERY SLING ISOLATED PULMONARY ARTERY ANEURYSM DYSPHAGIA LUSORIA PULMONARY VEIN ABNORMALITIES PULMONARY VARIX PULMONARY ARTERIOVENOUS MALFORMATIONS SCIMITAR SYNDROME CONCLUSION REFERENCES 10 Benign Lesions of the Lung INTRODUCTION DEFINITION AND INCIDENCE EVALUATION FOR AN INDETERMINATE PULMONARY NODULE INFLAMMATORY LUNG LESIONS INFECTIOUS GRANULOMATOSIS MYCOBACTERIUM SARCOIDOSIS WEGENER GRANULOMATOSIS OTHER INFECTIONS EPITHELIAL TUMORS ADENOMAS ALVEOLAR ADENOMA PAPILLARY ADENOMA OF TYPE 2 PNEUMOCYTES (CLARA CELL ADENOMA) MUCOUS GLAND ADENOMA MYOEPITHELIOMA MUCINOUS CYSTADENOMA PAPILLOMAS SQUAMOUS CELL PAPILLOMA GLANDULAR PAPILLOMA MIXED PAPILLOMA FIBROUS POLYPS MESENCHYMAL TUMORS ADIPOCYTE ORIGIN LIPOMAS ANGIOMYOLIPOMA CARTILAGE ORIGIN (CHONDROMA) FIBROBLAST ORIGIN BENIGN ENDOBRONCHIAL FIBROUS HISTIOCYTOMA INFLAMMATORY PSEUDOTUMOR SOLITARY FIBROUS TUMOR LYMPHATIC ORIGIN (SOLITARY INTRAPULMONARY LYMPHANGIOMA) PARAGANGLIOMA ORIGIN (PARAGANGLIOMAS) PERIPHERAL NERVE SHEATH ORIGIN GRANULAR CELL TUMOR SCHWANNOMAS SMOOTH MUSCLE ORIGIN (LEIOMYOMA) VASCULAR ORIGIN (SCLEROSING HEMANGIOMA) TUMORS OF MISCELLANEOUS ORIGIN HAMARTOMA NODULAR AMYLOID LESION CLEAR CELL TUMOR (SUGAR TUMOR) PRIMARY PULMONARY THYMOMA TERATOMA OTHER BENIGN LESIONS LYMPHANGIOLEIOMYOMATOSIS PULMONARY INFARCT CONCLUSION REFERENCES 11 Interstitial Lung Diseases GRANULOMATOUS PATTERNS OF INTERSTITIAL LUNG DISEASE FOREIGN BODIES AND INORGANIC DUST HYPERSENSITIVITY PNEUMONITIS INFECTIONS SARCOIDOSIS GRANULOMATOUS VASCULITIDES: GRANULOMATOSIS WITH POLYANGIITIS AND EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS EOSINOPHILIC PNEUMONIAS PULMONARY LANGERHANS CELL HISTIOCYTOSIS ALVEOLITIC PATTERNS OF INTERSTITIAL LUNG DISEASE DRUG-ASSOCIATED INJURY GOODPASTURE SYNDROME IDIOPATHIC INTERSTITIAL PNEUMONIA FAMILIAL FORMS OF IDIOPATHIC INTERSTITIAL PNEUMONIA IDIOPATHIC PULMONARY FIBROSIS DESQUAMATIVE INTERSTITIAL PNEUMONIA IDIOPATHIC NONSPECIFIC INTERSTITIAL PNEUMONIA ACUTE INTERSTITIAL PNEUMONITIS RESPIRATORY BRONCHIOLITIS–ASSOCIATED INTERSTITIAL LUNG DISEASE CRYPTOGENIC ORGANIZING PNEUMONIA LYMPHOCYTIC INTERSTITIAL PNEUMONIA IDIOPATHIC PLEUROPARENCHYMAL FIBROELASTOSIS UNCLASSIFIABLE IDIOPATHIC INTERSTITIAL PNEUMONIAS INTERSTITIAL LUNG DISEASE ASSOCIATED WITH CONNECTIVE TISSUE DISEASES DIFFUSE ALVEOLAR HEMORRHAGE SYNDROME LYMPHANGIOLEIOMYOMATOSIS PATIENT EVALUATION TREATMENT REFERENCES 12 Infectious Lung Diseases PNEUMONIA COMMUNITY-ACQUIRED PNEUMONIA CLINICAL PRESENTATION OF COMMUNITY-ACQUIRED PNEUMONIA DETERMINATION OF COMMUNITY-ACQUIRED PNEUMONIA SEVERITY TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA HOSPITAL-ACQUIRED (NOSOCOMIAL) PNEUMONIA VENTILATOR-ASSOCIATED PNEUMONIA ASPIRATION PNEUMONIA BRONCHIECTASIS LUNG ABSCESS PULMONARY MYCOBACTERIAL DISEASE MAJOR PULMONARY MYCOTIC INFECTIONS HISTOPLASMOSIS COCCIDIOIDOMYCOSIS BLASTOMYCOSIS ASPERGILLOSIS Aspergilloma INVASIVE ASPERGILLOSIS ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS CRYPTOCOCCOSIS MUCORMYCOSIS REFERENCES 13 Surgery for Emphysema PATHOPHYSIOLOGY SELECTION OF PATIENTS FOR SURGICAL TREATMENT OF EMPHYSEMA BULLECTOMY LUNG TRANSPLANTATION TECHNIQUES VOLUME REDUCTION TECHNIQUES COMBINATIONS OF LUNG TRANSPLANTATION AND LUNG VOLUME REDUCTION BRONCHOSCOPIC TREATMENT OF EMPHYSEMA ENDOSCOPIC PLACEMENT OF ONE-WAY VALVES AIRWAY BYPASS NITINOL AIRWAY COILS SUMMARY References 14 Lung Transplantation KEY POINTS HISTORY OF LUNG TRANSPLANTATION selection CANDIDATE LISTING LUNG ALLOCATION BRIDGE TO TRANSPLANT LUNG DONOR DONOR OPERATION PROCUREMENT BRAIN-DEAD DONOR DONOR BACK-TABLE PREPARATION NON–HEART-BEATING DONOR Intra-operative complications ATRIAL CUFF AND PULMONARY VEIN INJURIES PULMONARY ARTERIES CONGENITAL BRONCHIAL ANOMALIES RECIPIENT OPERATION ANESTHESIA AND INTRAOPERATIVE CONDUCT IMPLANTATION INCISIONS PNEUMONECTOMY LUNG IMPLANTATION INTRAOPERATIVE ECMO SUPPORT DELAYED CHEST CLOSURE POSTOPERATIVE MANAGEMENT VENTILATION FLUID MANAGEMENT GENERAL CARE IMMUNOSUPPRESSION INFECTION PROPHYLAXIS RECIPIENT COMPLICATIONS EARLY POSTOPERATIVE COMPLICATIONS TECHNICAL PROBLEMS PRIMARY GRAFT DYSFUNCTION ACUTE REJECTION CHRONIC COMPLICATIONS FAILURE OF NORMAL BRONCHIAL HEALING ANASTOMOTIC STENOSIS CHRONIC REJECTION POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER OUTCOMES AFTER LUNG TRANSPLANTATION SUMMARY REFERENCES 15 Lung Cancer Screening: Challenges for the Thoracic Surgeon HISTORY OF LUNG CANCER SCREENING CHEST RADIOGRAPHY SCREENING EARLY COMPUTED TOMOGRAPHY SCREENING STUDIES MODELING APPROACHES TO ESTIMATE MORTALITY BENEFIT The NLST and The NELSON Trial IMPORTANT STATISTICAL CONCEPTS OTHER APPROACHES TO SCREENING CURRENT RECOMMENDATIONS CURRENT BARRIERS TO LUNG CANCER SCREENING REPORTING AND MANAGEMENT OF THE SCREEN-DETECTED NODULE: THE LUNG CT SCREENING REPORTING AND DATA SYSTEM (LUNG-RADS) MEASURING LUNG NODULES MANAGEMENT OF SUSPICIOUS AND VERY SUSPICIOUS NODULES SUMMARY References 16 Lung Cancer Workup and Staging THE STAGING SYSTEM DIAGNOSIS AND STAGING HISTORY AND PHYSICAL EXAMINATION NONINVASIVE MODALITIES CHEST RADIOGRAPHY SPUTUM CYTOLOGY LOW-DOSE COMPUTED TOMOGRAPHY HIGH-RESOLUTION COMPUTED TOMOGRAPHY POSITRON EMISSION TOMOGRAPHY BONE SCAN MAGNETIC RESONANCE IMAGING INVASIVE MODALITIES BRONCHOSCOPY ENDOBRONCHIAL ULTRASOUND AUTOFLUORESCENCE BRONCHOSCOPY PERCUTANEOUS TRANSTHORACIC NEEDLE BIOPSY CERVICAL MEDIASTINOSCOPY LEFT ANTERIOR MEDIASTINOTOMY AND EXTENDED CERVICAL MEDIASTINOSCOPY SCALENE NODE BIOPSY VIDEO-ASSISTED THORACIC SURGERY THORACOTOMY METASTATIC WORKUP SUMMARY REFERENCES 17 Lung Cancer: Surgical Treatment HISTORICAL NOTE PULMONARY SURGICAL OPERATIONS: INDICATIONS AND TECHNIQUES LOBECTOMY POSITIONING AND INCISIONS MOBILIZATION AND HILAR DISSECTION MANAGEMENT OF VESSELS MANAGEMENT OF BRONCHUS PLACEMENT OF CHEST TUBES PNEUMONECTOMY INCISION HILAR DISSECTION MANAGEMENT OF BRONCHUS MANAGEMENT OF THE POSTPNEUMONECTOMY SPACE SUBLOBAR RESECTION (SEGMENTECTOMY AND WEDGE RESECTION) SURGICAL PRINCIPLES MEDIASTINAL LYMPH NODE DISSECTION RATIONALE TECHNIQUES SURGICAL TREATMENT OF NON–SMALL CELL LUNG CANCER T CATEGORY: T1 AND T2 SUBLOBAR RESECTION VERSUS LOBECTOMY FOR NODE-NEGATIVE, SMALL-SIZED NON–SMALL CELL LUNG CANCER T CATEGORY: T3 TUMORS INVADING THE CHEST WALL SUPERIOR SULCUS TUMORS TUMORS IN PROXIMITY TO THE CARINA TUMORS INVADING THE MEDIASTINUM SEPARATE NODULES IN THE PRIMARY LOBE T CATEGORY: T4 Diaphragm HEART AND GREAT VESSELS CARINA AND TRACHEA IPSILATERAL PULMONARY METASTASIS IN NONPRIMARY LOBES VERTEBRAL BODY ESOPHAGUS N CATEGORY: N0 AND N1 N CATEGORY: N2 N2 FOUND ON PRETREATMENT STAGING N2 FOUND AT THORACOTOMY N CATEGORY: N3 M CATEGORY: M1a ADDITIONAL NODULES IN THE CONTRALATERAL LUNG MALIGNANT PLEURAL EFFUSION M CATEGORY: M1b AND M1c ADRENAL GLAND BRAIN SPECIAL CONSIDERATIONS MEDIASTINAL LYMPH NODE DISSECTION VERSUS SYSTEMATIC SAMPLING OPERATIVE MORBIDITY STAGING ACCURACY LOCAL CONTROL AND LONG-TERM SURVIVAL MULTIFOCAL ADENOCARCINOMAS IN SITU, MINIMALLY INVASIVE ADENOCARCINOMAS, AND LEPIDIC PREDOMINANT ADENOCARCINOMAS TREATMENT STRATEGY AND OUTCOME SURGICAL TREATMENT OF SMALL CELL LUNG CANCER HISTORICAL NOTE RATIONALE FOR SURGERY IMPROVED LOCAL CONTROL MIXED-HISTOLOGY TUMORS SURGERY AS A SALVAGE TREATMENT TUMOR-NODE-METASTASIS STAGING (EIGHTH EDITION) AND SURGICAL OUTCOME SUMMARY REFERENCES 18 Minimally Invasive Approaches to Lung Cancer DEFINITION HISTORY INDICATIONS CONTRAINDICATIONS STRATEGY FOR THORACOSCOPIC LOBECTOMY VIDEO-ASSISTED THORACIC SURGERY RIGHT UPPER LOBECTOMY VIDEO-ASSISTED THORACIC SURGERY LEFT UPPER LOBECTOMY VIDEO-ASSISTED THORACIC SURGERY LOWER LOBECTOMY (RIGHT OR LEFT) VIDEO-ASSISTED THORACIC SURGERY MIDDLE LOBECTOMY VIDEO-ASSISTED THORACIC SURGERY BILOBECTOMY TECHNICAL CONSIDERATIONS ROBOT-ASSISTED THORACOSCOPIC LOBECTOMY EXTENDED LUNG RESECTIONS SUBLOBAR RESECTION POSTOPERATIVE CARE ENHANCED RECOVERY AFTER SURGERY RESULTS ONCOLOGIC EFFICACY OVERALL COMPLICATIONS, MORBIDITY, AND MORTALITY POSTOPERATIVE PAIN AND QUALITY OF LIFE PULMONARY FUNCTION SYSTEMIC INFLAMMATION COST-EFFECTIVENESS VIDEO-ASSISTED THORACIC SURGERY VERSUS ROBOT-ASSISTED THORACIC SURGERY SUMMARY References 19 Lung Cancer: Multimodal Therapy INTRODUCTION NEOADJUVANT THERAPY FOLLOWED BY SURGERY CHEMOTHERAPY CHEMORADIATION TARGETED THERAPIES IMMUNOTHERAPY ADJUVANT THERAPY CHEMOTHERAPY TARGETED THERAPY AND IMMUNOTHERAPY POSTOPERATIVE RADIOTHERAPY (PORT) ADJUVANT THERAPY FOLLOWING R1 RESECTION SURGICAL SALVAGE LOCAL CONSOLIDATIVE THERAPY FOR OLIGOMETASTATIC DISEASE CONCLUSION References 20 Lung Cancer: Surgical Strategies for Tumors Invading the Chest Wall INTRODUCTION AND HISTORY DEMOGRAPHICS AND SYMPTOMS DIAGNOSIS STAGING TREATMENT PREOPERATIVE ASSESSMENT OPERATIVE TECHNIQUES RECONSTRUCTION POSTOPERATIVE CARE COMPLICATIONS PATHOLOGY RESULTS SUMMARY CLINICAL SCENARIO REFERENCES 21 Anterior Approach to Superior Sulcus Lesions HISTORICAL NOTE CLINICAL PRESENTATION PREOPERATIVE EVALUATION MULTIDISCIPLINARY MANAGEMENT OF PANCOAST TUMORS MULTIMODAL TREATMENT, SURVIVAL, AND RECURRENCE SURGICAL TREATMENT ZONES 1, 2, AND 3—ANTERIOR APPROACHES THE DARTEVELLE APPROACH THE GRUNENWALD APPROACH THE NAZZARO APPROACH THE MASAOKA APPROACH THE ADDITION OF VIDEO-ASSISTED THORACOSCOPIC SURGERY ZONES 4 AND 5—POSTERIOR APPROACHES THE PAULSON APPROACH THE HOOK APPROACH SUMMARY References 22 Other Primary Tumors of the Lung BRONCHOPULMONARY CARCINOID TUMORS INTRODUCTION EPIDEMIOLOGY PATHOLOGY GENETICS CLINICAL PRESENTATION DIAGNOSIS BRONCHOSCOPY RADIONUCLIDE IMAGING OF BRONCHOPULMONARY CARCINOID TUMORS SOMATOSTATIN RECEPTOR SCINTIGRAPHY AND POSITRON EMISSION TOMOGRAPHY 68Ga-DOTATATE PET/CT BIOCHEMICAL ASSESSMENT AND TUMOR MARKERS MANAGEMENT AND TREATMENT SURGERY ADJUVANT THERAPIES: RADIATION, CHEMOTHERAPY, AND TARGETED THERAPY SYSTEMIC THERAPIES Somatostatin Analogs mTOR INHIBITORS PEPTIDE RECEPTOR RADIONUCLIDE THERAPY CHEMOTHERAPY PROGNOSIS FOLLOW-UP DIFFUSE IDIOPATHIC PULMONARY NEUROENDOCRINE CELL HYPERPLASIA PRIMARY PULMONARY SALIVARY GLAND–TYPE TUMORS EPIDEMIOLOGY PATHOLOGY CLINICAL PRESENTATION DIAGNOSIS MANAGEMENT AND TREATMENT PROGNOSIS PULMONARY SARCOMATOID CARCINOMAS PATHOLOGY EPIDEMIOLOGY, TREATMENT, AND PROGNOSIS PRIMARY PULMONARY SARCOMAS EPIDEMIOLOGY CLINICAL PRESENTATION TREATMENT PROGNOSIS PRIMARY PULMONARY SYNOVIAL SARCOMA PRIMARY PULMONARY EPITHELIOID HEMANGIOENDOTHELIOMA PULMONARY ARTERY INTIMAL SARCOMA INTRODUCTION CLINICAL FEATURES IMAGING STUDIES TREATMENT AND PROGNOSIS PRIMARY PULMONARY LYMPHOMAS MUCOSA-ASSOCIATED LYMPHOID TISSUE EPIDEMIOLOGY CLINICAL PRESENTATION TREATMENT AND PROGNOSIS PRIMARY PULMONARY DIFFUSE LARGE B-CELL LYMPHOMA EPIDEMIOLOGY AND CLINICAL PRESENTATION PROGNOSIS PRIMARY PULMONARY (EXTRAMEDULLARY) PLASMACYTOMA EPIDEMIOLOGY AND CLINICAL PRESENTATION TREATMENT AND PROGNOSIS PRIMARY PULMONARY MELANOMA EPIDEMIOLOGY PATHOLOGY CLINICAL PRESENTATION AND DIAGNOSIS TREATMENT THORACIC NUCLEAR PROTEIN IN TESTIS CARCINOMA EPIDEMIOLOGY PATHOLOGY CLINICAL PRESENTATION, TREATMENT, AND PROGNOSIS SUMMARY REFERENCES 23 Secondary Lung Tumors HISTORY OF METASTASECTOMY PATHOPHYSIOLOGY OF PULMONARY METASTASES DO METASTASES METASTASIZE? DOES LUNG CANCER METASTASIZE TO THE LUNG? EVALUATION OF THE PATIENT WITH SECONDARY PULMONARY TUMORS SYMPTOMS AND PRESENTATION RADIOGRAPHIC EVALUATION TISSUE DIAGNOSIS INDICATIONS FOR SURGERY SURGICAL APPROACH LYMPH NODE DISSECTION RESULTS OF PULMONARY METASTASECTOMY SPECIFIC SECONDARY LUNG TUMORS SOFT TISSUE SARCOMA OSTEOSARCOMA (OSTEOGENIC SARCOMA) COLORECTAL CANCER BREAST CARCINOMA HEAD AND NECK CARCINOMA RENAL CELL CARCINOMA GERM CELL TUMORS GYNECOLOGIC TUMORS MELANOMA ENDOCRINE TUMORS OTHER TUMORS ALTERNATIVE TREATMENT OPTIONS PALLIATIVE THERAPY CONCLUSIONS References 24 Congenital Chest Wall Deformities PECTUS EXCAVATUM ETIOLOGY AND INCIDENCE SYMPTOMS PATHOPHYSIOLOGY PULMONARY FUNCTION STUDIES CARDIOVASCULAR STUDIES ECHOCARDIOGRAPHIC STUDIES OF MITRAL VALVE PROLAPSE SURGICAL REPAIR MINIMALLY INVASIVE REPAIR OF PECTUS EXCAVATUM POSTOPERATIVE PAIN MANAGEMENT OPEN SURGICAL REPAIR OF PECTUS EXCAVATUM REPAIR OF RECURRENT PECTUS EXCAVATUM ACQUIRED RESTRICTIVE THORACIC DYSTROPHY NONOPERATIVE TREATMENT OF PECTUS EXCAVATUM PECTUS CARINATUM ETIOLOGY SURGICAL REPAIR SURGICAL TECHNIQUE OPERATIVE RESULTS NONOPERATIVE CORRECTION OF PECTUS CARINATUM POLAND SYNDROME SURGICAL REPAIR STERNAL DEFECTS CLEFT STERNUM SURGICAL REPAIR ECTOPIA CORDIS ETIOLOGY THORACIC ECTOPIA CORDIS THORACOABDOMINAL ECTOPIA CORDIS (CANTRELL PENTALOGY) THORACIC DEFORMITIES IN DIFFUSE SKELETAL DISORDERS ASPHYXIATING THORACIC DYSTROPHY (JEUNE SYNDROME) SPONDYLOTHORACIC DYSPLASIA (JARCHO-LEVIN SYNDROME) REFERENCES 25 Chest Wall Tumors KEY POINTS PRESENTATION AND EVALUATION HISTORY PHYSICAL EXAMINATION IMAGING PREOPERATIVE EVALUATION SURGICAL MANAGEMENT PREOPERATIVE BIOPSY ANESTHETIC CONSIDERATIONS INTRAOPERATIVE CONSIDERATIONS RECONSTRUCTION ROLE OF 3D PRINTING POSTOPERATIVE CARE FOLLOW-UP AND PROGNOSTIC FACTORS SPECIFIC LESIONS BENIGN LESIONS OSTEOCHONDROMA CHONDROMA FIBROUS DYSPLASIA EOSINOPHILIC GRANULOMA HEMANGIOMA NEUROFIBROMA/NEURILEMMOMA DESMOID TUMORS MALIGNANT LESIONS CHONDROSARCOMA OSTEOSARCOMA EWING SARCOMA FAMILY TUMORS PLASMACYTOMA OTHER SARCOMAS SUMMARY REFERENCES 26 Thoracic Outlet Syndrome and Dorsal Sympathectomy HISTORY OF THORACIC OUTLET SYNDROME SURGICAL ANATOMY OF THORACIC OUTLET SYNDROME FUNCTIONAL ANATOMY OF THORACIC OUTLET SYNDROME COMPRESSION FACTORS OF THORACIC OUTLET SYNDROME SYMPTOMS AND SIGNS OF THORACIC OUTLET SYNDROME DIAGNOSIS CLINICAL MANEUVERS RADIOGRAPHIC FINDINGS NERVE CONDUCTION VELOCITY AND ELECTROMYOGRAPHY METHOD OF MEASURING CONDUCTION VELOCITIES EQUIPMENT Nerve Conduction to Diagnosis Thoracic Outlet Syndrome CALCULATION OF NERVE VELOCITIES NORMAL ULNAR NERVE CONDUCTION VELOCITIES GRADING OF COMPRESSION ANGIOGRAPHY Magnetic Resonance (MR) Imaging DIFFERENTIAL DIAGNOSIS THERAPY FOR THORACIC OUTLET SYNDROME URSCHEL/MCKENNA TECHNIQUE OF TRANSAXILLARY RESECTION OF THE FIRST RIB MCKENNA TECHNIQUE OF VIDEO-ASSISTED THORACIC SURGERY TRANSAXILLARY RESECTION OF THE FIRST RIB EFFORT THROMBOSIS: PAGET-SCHROETTER SYNDROME SYMPATHECTOMY WITH VIDEO-ASSISTED THORACIC SURGERY FOR THORACIC OUTLET SYNDROME PATHOPHYSIOLOGY INDICATIONS FOR SYMPATHECTOMY COMPLICATIONS HORNER SYNDROME POSTSYMPATHECTOMY NEURALGIA RECURRENT SYMPTOMS SURGICAL APPROACHES FOR DORSAL SYMPATHECTOMY VARIATIONS OF DORSAL SYMPATHECTOMY TECHNIQUE URSCHEL TRANSAXILLARY APPROACH WITH A TRANSTHORACIC SYMPATHECTOMY URSCHEL TRANSAXILLARY FIRST RIB RESECTION FOR THORACIC OUTLET SYNDROME WITH RETRACTION OF THE PLEURA AND SYMPATHECTOMY RESULTS REOPERATION FOR RECURRENT THORACIC OUTLET SYNDROME OPERATIVE TECHNIQUE FOR REDOING THORACIC OUTLET SYNDROME SURGERY SUMMARY ACKNOWLEDGMENT References 27 Spontaneous Pneumothorax EPIDEMIOLOGY CAUSES CLINICAL PRESENTATION IMAGING MANAGEMENT OBSERVATION ASPIRATION TUBE THORACOSTOMY PLEURODESIS SURGERY SPECIAL CONSIDERATIONS SECONDARY SPONTANEOUS PNEUMOTHORAX CATAMENIAL PNEUMOTHORAX REFERENCES 28 Empyema EPIDEMIOLOGY HISTORICAL REVIEW BACTERIOLOGY PATHOGENESIS DIAGNOSIS: CLINICAL SIGNS AND SYMPTOMS, FLUID ANALYSIS, AND RADIOLOGIC APPEARANCE TREATMENT SPECIAL CONSIDERATIONS: POSTPNEUMONECTOMY EMPYEMA AND BRONCHOPLEURAL FISTULA INCIDENCE TREATMENT USE OF VACUUM-ASSISTED CLOSURE IN MANAGEMENT OF COMPLEX PLEURAL SPACES75 CONCLUSIONS REFERENCES 29 Chylothorax KEY POINTS DEFINITION CLASSIFICATION AND ETIOLOGY ANATOMIC CONSIDERATIONS PATHOPHYSIOLOGY SYMPTOMS AND DIAGNOSIS PRINCIPLES OF TREATMENT CHYLOTHORAX AFTER PULMONARY RESECTION CHYLOTHORAX AFTER ESOPHAGECTOMY CHYLOTHORAX AFTER LUNG TRANSPLANTATION CONCLUSION References 30 Malignant Pleural and Pericardial Effusions MALIGNANT PLEURAL EFFUSIONS PHYSIOLOGY DEMOGRAPHICS EVALUATION HISTORICAL AND PHYSICAL FINDINGS IMAGING DIAGNOSTIC PROCEDURES STANDARD CHEMISTRY AND CELL COUNTS PLEURAL CYTOLOGY AND BIOPSY TREATMENT DRAINAGE-BASED METHODS OF MALIGNANT EFFUSION CONTROL Small Catheter Drainage Pleuroperitoneal Shunting SCLEROSIS-BASED PLEURAL EFFUSION MANAGEMENT Chemical Sclerosis—Talc Chemical Sclerosis—Cycline Drugs and Bleomycin Other Sclerosing Compounds RADIOPHARMACEUTICAL INTERVENTIONS MECHANICAL ABRASION OR LASER PLEURECTOMY PROGNOSIS AND FUTURE TRENDS MALIGNANT PERICARDIAL EFFUSIONS MECHANISM EVALUATION TREATMENT References 31 Pleural Tumors INTRODUCTION FUNDAMENTALS OF PLEURAL TUMOR BIOLOGY PLEURAL DEVELOPMENT, ANATOMY, AND PHYSIOLOGY ASBESTOS AND PLEURAL DISEASE GENERAL CLINICAL FEATURES OF PLEURAL TUMORS CLINICAL FEATURES OF MALIGNANT PLEURAL MESOTHELIOMA MESOTHELIOMA IN SITU LOCALIZED MALIGNANT MESOTHELIOMA DIFFUSE MALIGNANT MESOTHELIOMA OVERVIEW CLINICAL PRESENTATION DIAGNOSIS Tissue Sampling Histopathology Molecular Features STAGING PROGNOSIS TREATMENT MANAGEMENT OF MALIGNANT PLEURAL MESOTHELIOMA OPERATIVE TECHNIQUE: PLEURECTOMY/DECORTICATION OPERATIVE TECHNIQUE: EXTRAPLEURAL PNEUMONECTOMY INTRAOPERATIVE ADJUNCTS POSTOPERATIVE MANAGEMENT NON-SURGICAL MANAGEMENT OF MALIGNANT PLEURAL MESOTHELIOMA CHEMOTHERAPY RADIATION THERAPY IMMUNOTHERAPY BEYOND MESOTHELIOMA: OTHER PLEURAL TUMORS BENIGN PLEURAL LESIONS INFLAMMATORY PLEURAL REACTIONS BENIGN AND PREMALIGNANT PLEURAL NEOPLASMS FIBROBLASTIC AND MYOFIBROBLASTIC TUMORS VASCULAR TUMORS PERIPHERAL NERVE SHEATH TUMORS PLEUROPULMONARY SYNOVIAL SARCOMA PLEUROPULMONARY BLASTOMA ASKIN TUMOR OR PRIMITIVE NEUROECTODERMAL TUMOR SMALL ROUND CELL TUMOR PLEURAL METASTASES AND MALIGNANT EFFUSION CONCLUSION REFERENCES 32 Surgery of the Diaphragm: A Deductive Approach EMBRYOLOGY STRUCTURE AND FUNCTION PLEURAL AND PERITONEAL ATTACHMENTS ARTERIAL AND VENOUS ANATOMY LYMPHATICS DIAPHRAGMATIC INNERVATION DIAGNOSIS OF DIAPHRAGM PATHOLOGY DIAPHRAGMATIC INCISIONS TRAUMATIC DIAPHRAGMATIC INJURY DIAPHRAGMATIC ELEVATION DIAPHRAGMATIC HERNIAS DIAPHRAGMATIC PACING ONCOLOGY OF THE DIAPHRAGM DIAPHRAGMATIC RESECTION AND REPAIR WITH PROSTHETIC PATCH SUMMARY REFERENCES 33 Congenital Diaphragmatic Hernia DEFINITION HISTORY EPIDEMIOLOGY EMBRYOLOGY OF THE DIAPHRAGM PATHOLOGY ETIOLOGY PATHOGENESIS PATHOLOGIC ANATOMY GROSS FINDINGS MICROSCOPY PATHOPHYSIOLOGY CLINICAL MANIFESTATIONS DIAGNOSIS ASSOCIATED ANOMALIES PROGNOSTIC FACTORS TREATMENT FETAL INTERVENTION PREOPERATIVE CARE DELIVERY ROOM VENTILATOR MANAGEMENT ADDITIONAL PREOPERATIVE STUDIES PULMONARY HYPERTENSION MANAGEMENT NITRIC OXIDE PULMONARY VASODILATORS SURFACTANT ALTERNATIVE FORMS OF MECHANICAL VENTILATION EXTRACORPOREAL MEMBRANE OXYGENATION SURGERY POSTOPERATIVE CARE LATE-PRESENTATION CONGENITAL DIAPHRAGMATIC HERNIA RESULTS LONG-TERM FOLLOW-UP DIAPHRAGMATIC HERNIA RECURRENCE FUTURE DIRECTIONS OTHER DIAPHRAGMATIC ANOMALIES DIAPHRAGMATIC EVENTRATION MORGAGNI HERNIA HIATAL HERNIA PERICARDIAL HERNIA DIAPHRAGMATIC AGENESIS DIAPHRAGMATIC DUPLICATION CRIBRIFORM DIAPHRAGM References 34 Esophageal Anatomy and Function ANATOMY OVERVIEW, SURROUNDING STRUCTURES, AND ANCHORS OF THE ESOPHAGUS CERVICAL ESOPHAGUS THORACIC ESOPHAGUS Abdominal Esophagus STRUCTURE OF THE ESOPHAGEAL WALL BLOOD SUPPLY, LYMPHATICS, AND INNERVATION EMBRYOLOGY PHYSIOLOGY THE SWALLOWING MECHANISM INITIATION OROPHARYNGEAL PHASE ESOPHAGEAL PHASE UPPER ESOPHAGEAL SPHINCTER ESOPHAGEAL BODY AND ESOPHAGEAL PERISTALSIS LOWER ESOPHAGEAL SPHINCTER CAUSES AND CONSEQUENCES OF THE FAILURE OF THE GASTROESOPHAGEAL BARRIER EVALUATION OF ESOPHAGEAL FUNCTION RADIOGRAPHIC EVALUATION ENDOSCOPIC EXAMINATION ESOPHAGEAL MANOMETRY LOWER ESOPHAGEAL SPHINCTER LOWER ESOPHAGEAL SPHINCTER RELAXATION ESOPHAGEAL BODY MOTILITY UPPER ESOPHAGEAL SPHINCTER HIGH-RESOLUTION IMPEDANCE FUNCTIONAL LUMINAL IMAGING PROBE AMBULATORY pH MONITORING ACKNOWLEDGMENTS References 35 Surgery for Congenital Lesions of the Esophagus INTRODUCTION ESOPHAGEAL ATRESIA HISTORICAL ASPECTS EPIDEMIOLOGY ANATOMY PRESENTATION WORK-UP INITIAL MANAGEMENT OPERATIVE PRINCIPLES COMPLICATIONS AND LONG-TERM EFFECTS ESOPHAGEAL DUPLICATIONS ANATOMY AND EMBRYOLOGY INCIDENCE PRESENTATION DIAGNOSIS TREATMENT CONGENITAL ESOPHAGEAL STENOSIS ANATOMY PRESENTATION DIAGNOSIS TREATMENT LARYNGOTRACHEOESOPHAGEAL CLEFT ANATOMY PRESENTATION DIAGNOSIS TREATMENT REFERENCES 36 Surgical Treatment of Benign Esophageal Diseases THE ESOPHAGUS AND ITS SURROUNDINGS ESOPHAGEAL WALL REGIONAL ANATOMY ESOPHAGEAL FUNCTION EVALUATION OF THE ESOPHAGUS HISTORY AND PHYSICAL EXAMINATION INVESTIGATIONS BARIUM ESOPHAGRAM ESOPHAGOSCOPY ESOPHAGEAL MANOMETRY IMPEDANCE MANOMETRY pH MONITORING IMPEDANCE-pH MONITORING ENDOSCOPIC ESOPHAGEAL ULTRASOUND ENDOFLIP BENIGN ESOPHAGEAL DISEASES AND THEIR TREATMENT GASTROESOPHAGEAL REFLUX DISEASE BARRETT ESOPHAGUS HIATAL HERNIA MOTILITY DISORDERS ACHALASIA HYPERCONTRACTILE AND SPASTIC DISORDERS HYPOMOTILITY DISORDERS SECONDARY ESOPHAGEAL MOTILITY DISORDERS DIVERTICULA ZENKER DIVERTICULUM MIDTHORACIC DIVERTICULUM EPIPHRENIC DIVERTICULUM BENIGN ESOPHAGEAL TUMORS AND CYSTS TUMORS OF THE MUCOSA TUMORS OF THE SUBMUCOSA TUMORS OF THE MUSCULARIS PROPRIA ESOPHAGEAL CYSTS ESOPHAGEAL INJURIES STRICTURES CAUSES OF ESOPHAGEAL STRICTURES CORROSIVE INJURIES Early Management Late Management PERFORATION ESOPHAGEAL FOREIGN BODIES CONCLUSION References 37 Staging Techniques for Carcinoma of the Esophagus ESOPHAGEAL CANCER TUMOR-NODE-METASTASIS STAGING ENDOSCOPIC ULTRASONOGRAPHY ENDOSCOPIC ULTRASOUND AND NEOADJUVANT THERAPY Metastatic Disease ENDOSCOPIC MUCOSAL RESECTION COMPUTED TOMOGRAPHY POSITRON EMISSION TOMOGRAPHY–COMPUTED TOMOGRAPHY INITIAL STAGING INTERVAL STAGING RESTAGING SURGICAL STAGING BRAIN IMAGING MOLECULAR STAGING: PROGNOSTIC BIOMARKERS SUMMARY REFERENCES 38 Esophageal Resection and Replacement HISTORY OF ESOPHAGEAL RESECTION MODIFIED MCKEOWN OR TRI-INCISIONAL TECHNIQUE INDICATIONS CONTRAINDICATIONS PREPARATION TECHNIQUE IVOR LEWIS ESOPHAGECTOMY INDICATIONS CONTRAINDICATIONS TECHNIQUE TRANSHIATAL ESOPHAGECTOMY INDICATIONS CONTRAINDICATIONS PREPARATION TECHNIQUE TRIALS COMPARING TRANSHIATAL WITH TRANSTHORACIC RESECTION MINIMALLY INVASIVE ESOPHAGECTOMY MINIMALLY INVASIVE TRI-INCISIONAL ESOPHAGECTOMY Indications Contraindications Technique Video-Assisted Thoracoscopic Mobilization of the Thoracic Esophagus. Laparoscopic Mobilization of the Gastric Conduit, Pyloroplasty, and Formation of a Jejunostomy Tube. MINIMALLY INVASIVE IVOR LEWIS ESOPHAGECTOMY MINIMALLY INVASIVE TRANSHIATAL ESOPHAGECTOMY RESULTS OF MINIMALLY INVASIVE ESOPHAGECTOMY SURGICAL VARIATIONS OF MINIMALLY INVASIVE ESOPHAGECTOMY Minimally Invasive Esophagectomy in the Prone Position Robotic Esophagectomy Abdominal Approach. Thoracic Approach. Outcomes. LEFT THORACOABDOMINAL APPROACH INDICATIONS CONTRAINDICATIONS TECHNIQUE EN BLOC RESECTION TECHNIQUE RESULTS TECHNIQUES OF ALTERNATIVE CONDUITS: COLON AND JEJUNUM COLON Indications Contraindications Preparation LEFT COLON RIGHT COLON JEJUNUM Indications Contraindications Preparation Roux-en-Y Replacement Pedicled Jejunal Interposition Free Jejunal Interposition Common Operative Issues Intraoperative Assessment of Margins Management Approaches to the Pylorus. THREE-FIELD LYMPH NODE DISSECTION Prognostic Significance of Number of Lymph Nodes Resected. CONSIDERATIONS IN ESOPHAGEAL RESECTION PERIOPERATIVE MORTALITY EARLY PERIOPERATIVE COMPLICATIONS IMPLICATIONS OF ANASTOMOTIC LEAK AND MANAGEMENT STRATEGIES RESPIRATORY COMPLICATIONS RECURRENT LARYNGEAL NERVE INJURY BLEEDING CHYLE LEAK CARDIOVASCULAR MORBIDITY LATE PERIOPERATIVE COMPLICATIONS ANASTOMOTIC STRICTURE POSTRESECTION REFLUX IMPAIRED CONDUIT EMPTYING LOCAL RECURRENCE LONG-TERM (5-YEAR) SURVIVAL SUMMARY REFERENCES 39 Multimodality Therapy for Esophageal Cancer OVERVIEW: PRINCIPLES OF MULTIMODALITY THERAPY CLINICAL STAGING NEOADJUVANT THERAPIES NEOADJUVANT CHEMOTHERAPY VERSUS SURGERY ALONE NEOADJUVANT CHEMORADIATION VERSUS SURGERY ALONE NEOADJUVANT CHEMOTHERAPY VERSUS NEOADJUVANT CHEMORADIATION DEFINITIVE CHEMORADIATION SELECTIVE SURGERY ADJUVANT THERAPIES EMERGING ROLE OF TARGETED THERAPY AND IMMUNOTHERAPY IN MULTIMODAL TREATMENT FUTURE DIRECTIONS CONCLUSION REFERENCES 40 Mediastinal Anatomy and Mediastinoscopy MEDIASTINAL ANATOMY POTENTIAL SPACES IN THE MEDIASTINUM MEDIASTINAL LYMPH NODE ANATOMY INDICATIONS FOR MEDIASTINAL LYMPH NODE ASSESSMENT EFFICACY AND UTILITY OF MEDIASTINOSCOPY PREOPERATIVE EVALUATION POTENTIAL COMPLICATIONS OF MEDIASTINOSCOPY SURGICAL TECHNIQUE HIGH PARATRACHEAL DISSECTION LOWER PARATRACHEAL DISSECTION CARINAL DISSECTION NODE BIOPSY TECHNIQUE AND CLOSURE OF THE INCISION MANAGEMENT OF MAJOR BLEEDING EXTENDED MEDIASTINOSCOPY ENDOSCOPIC TECHNIQUES FOR MEDIASTINAL LYMPH NODE ASSESSMENT REFERENCES 41 Anterior Mediastinal Masses THYMIC TUMORS THYMOMA PATHOLOGY CLASSIFICATION PRESENTATION ASSOCIATION WITH MYASTHENIA GRAVIS ASSOCIATION WITH OTHER DISEASES THE ANTERIOR MEDIASTINAL MASS THAT MIGHT BE THYMOMA Imaging Serum Studies Evaluation for Myasthenia Gravis Biopsy TREATMENT Surgery Adjuvant Therapies OUTCOME THYMIC CARCINOMA NEUROENDOCRINE TUMORS OF THE THYMUS OTHER ABNORMALITIES OF THE THYMUS HYPERPLASIA THYMOLIPOMA THYMIC CYSTS GERM CELL TUMORS MATURE MEDIASTINAL TERATOMA MALIGNANT MEDIASTINAL GERM CELL TUMORS LYMPHOMAS SUBSTERNAL THYROID MEDIASTINAL PARATHYROID ADENOMA SURGICAL APPROACHES TO BIOPSY CHAMBERLAIN PROCEDURE (ANTERIOR MEDIASTINOTOMY) TRANSCERVICAL BIOPSY (CERVICAL MEDIASTINOTOMY) THORACOSCOPIC BIOPSY EXTENDED MEDIASTINOSCOPY THERAPEUTIC SURGICAL PROCEDURES: TECHNIQUES OF THYMECTOMY THYMECTOMY BY MEDIAN STERNOTOMY TRANSCERVICAL THYMECTOMY “MAXIMAL” THYMECTOMY: TRANS-STERNAL AND TRANSCERVICAL THORACOSCOPIC THYMECTOMY ROBOTIC-ASSISTED THYMECTOMY SUMMARY REFERENCES 42 The Middle Mediastinum ANATOMY DIAGNOSTIC MODALITIES SIGNS AND SYMPTOMS IMAGING INVASIVE TECHNIQUES COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS BIOPSY Endoscopic Ultrasound and Endobronchial Ultrasound-Guided Biopsy CERVICAL MEDIASTINOSCOPY AND ANTERIOR MEDIASTINOTOMY VIDEO-ASSISTED THORACOSCOPIC SURGERY AND ROBOT-ASSISTED SURGERY DISEASES OF THE MIDDLE MEDIASTINUM MEDIASTINAL LYMPHADENOPATHY TRACHEAL DISORDERS MEDIASTINAL CYSTS MIDDLE MEDIASTINAL MASSES PERICARDIAL DISORDERS MEDIASTINAL INFECTIONS REFERENCES 43 The Posterior Mediastinum ANATOMY AND IMAGING EPIDEMIOLOGY DIAGNOSIS SURGICAL APPROACHES TO THE POSTERIOR MEDIASTINUM LESIONS OF THE MEDIASTINUM NEUROGENIC TUMORS ESOPHAGEAL MASSES CYSTS OF THE POSTERIOR MEDIASTINUM BRONCHOGENIC CYSTS GASTROENTERIC CYSTS NEUROENTERIC CYSTS OTHER MASSES OF THE POSTERIOR MEDIASTINUM INFECTIONS OF THE MEDIASTINUM SUMMARY References 44 Surgical Treatment of Hyperhidrosis PATHOGENESIS TYPES OF HYPERHIDROSIS NONSURGICAL TREATMENT SURGICAL TREATMENT NOMENCLATURE FOR SYMPATHETIC SURGERY REVIEW OF PUBLISHED LITERATURE PATIENT SELECTION FOR ENDOSCOPIC THORACIC SYMPATHECTOMY FOR HYPERHIDROSIS TREATMENT LOCATION OF INTERRUPTION OF SYMPATHETIC CHAIN BASED ON PATIENT’S DISTRIBUTION OF SWEATING PALMAR HYPERHIDROSIS AXILLARY HYPERHIDROSIS CRANIOFACIAL HYPERHIDROSIS TYPE OF INTERRUPTION COMPLICATIONS OTHER SURGICAL TREATMENTS FOR HYPERHIDROSIS CONCLUSIONS References 45 The Molecular Biology of Thoracic Malignancies MECHANISMS OF ONCOGENESIS AND METASTASIS ENVIRONMENTAL EXPOSURE GENETIC MUTATIONS HETEROGENEITY OF MUTATIONS DEOXYRIBONUCLEIC ACID ANEUPLOIDY CHROMOTHRIPSIS DYSREGULATION OF CELLULAR PROLIFERATION CANCER STEM CELLS GENOMICS AND TRANSCRIPTOMICS EPIGENETICS PROTEOMICS METABOLOMICS CLINICAL APPLICATION OF NUCLEIC ACID AND PROTEIN BIOMARKERS SPECIFIC ALTERATIONS LUNG CANCER p53 ERCC1 k-ras Epidermal Growth Factor Receptor EML4-ALK Vascular Endothelial Growth Factor BRAF MET ROS1 RET NTRK1/2/3 ERBB2/HER-2 PD-1 and PD-L1 Tumor Panels Microarray Analysis and Molecular Profiling Proteomic Analysis ESOPHAGEAL CANCER Her2 VEGF PD-L1 Microarray Analysis Molecular Profiling MESOTHELIOMA BAP1 Microarray Analyses Molecular Profiling DETECTION OF CANCER IN LYMPH NODE TISSUE LUNG CANCER ESOPHAGEAL CANCER DETECTION IN BLOOD LUNG CANCER Nucleic Acids Proteins ESOPHAGEAL CANCER MESOTHELIOMA DETECTION IN BONE MARROW LUNG CANCER DETECTION IN SPUTUM LUNG CANCER PERSONALIZED ONCOLOGY CUSTOMIZED CHEMOTHERAPY TARGETED THERAPIES IMMUNOTHERAPY SUMMARY REFERENCES 46 Innovations in Thoracic Surgery INTRODUCTION ROBOTIC THORACIC SURGERY ROBOTIC-ASSISTED SURGERY VERSUS VIDEO-ASSISTED THORACOSCOPIC SURGERY ROBOTIC-ASSISTED SEGMENTECTOMY AND NEAR-INFRARED FLUORESCENCE COMPLEX ROBOTIC SURGERY OPERATIONS Single-Port Mediastinal Robotic Surgery Robotic-Assisted Minimally Invasive Esophagectomy Tracheobronchoplasty First Rib Resection CONCLUSION ENDOBRONCHIAL TECHNIQUES ENDOBRONCHIAL TECHNIQUES FOR BIOPSY AND STAGING ELECTROMAGNETIC NAVIGATIONAL BRONCHOSCOPY ROBOTIC NAVIGATIONAL BRONCHOSCOPY PREPROCEDURAL LOCALIZATION TECHNIQUES CONCLUSION ADVANCED IMAGING IN THORACIC SURGERY THREE-DIMENSIONAL PRINTING THREE-DIMENSIONAL IMAGING AND SEGMENTECTOMY ABLATIVE TECHNIQUES IN THORACIC SURGERY RADIOFREQUENCY ABLATION MICROWAVE ABLATION CRYOABLATION CONCLUSION SUMMARY References 47 Surgical Anatomy of the Heart LOCATION OF THE HEART MORPHOLOGICALLY RIGHT ATRIUM MORPHOLOGICALLY LEFT ATRIUM MORPHOLOGICALLY RIGHT VENTRICLE MORPHOLOGICALLY LEFT VENTRICLE AORTA PULMONARY TRUNK AND ITS BRANCHES CORONARY ARTERIES AND VEINS ACKNOWLEDGMENTS REFERENCES 48 Vascular Physiology INTRODUCTION VASCULAR RESISTANCE REGULATION OF VASCULAR TONE INTRINSIC AND EXTRINSIC VASOMOTOR CONTROL ROLE OF THE ENDOTHELIUM NITRIC OXIDE ENDOTHELIUM-DERIVED HYPERPOLARIZATION PROSTAGLANDIN ROLE OF METABOLISM AND AUTOREGULATION FLOW-INDUCED DILATION NEUROHUMORAL INFLUENCE ON MICROCIRCULATION INTRINSIC MYOGENIC TONE IMPACT OF EXTRAVASCULAR AND HUMORAL FORCES ON THE MICROCIRCULATION ROLE OF VENULES IN VASCULAR RESISTANCE ENDOTHELIAL FACTORS IN VASCULAR GROWTH AND RESPONSE TO INJURY EFFECT OF DISEASE STATES ON CORONARY CIRCULATION INFLUENCE OF SEX PULMONARY VASCULAR PHYSIOLOGY EFFECTS OF CARDIOVASCULAR SURGERY ON VASOMOTOR REGULATION IMPROVING MYOCARDIAL PERFUSION ANGIOGENESIS CHALLENGES AND FUTURE DIRECTIONS SUMMARY REFERENCES 49 Cellular Physiology of the Myocardium INTRODUCTION: INTEGRATION OF THE CELLULAR BIOLOGY AND PHYSIOLOGY OF THE MYOCARDIUM THE CARDIAC CYCLE REFLECTED IN PROPERTIES OF THE WORKING MYOCYTES INCREASES IN CARDIAC VOLUMES AND OUTPUT DURING EXERCISE REFLECT CELLULAR MECHANISMS MYOCYTE MECHANISMS IN THE DIASTOLIC/SYSTOLIC TRANSITION LEFT VENTRICULAR DIASTOLIC AND SYSTOLIC PRESSURE, EJECTION, AND RELAXATION REFLECT SARCOMERIC MECHANICAL PROPERTIES CELLULAR MECHANISMS OF CHEMO-MECHANICAL COUPLING CELLULAR MECHANISMS OF ELECTRO-CHEMICAL COUPLING INTEGRATED CELLULAR MECHANISMS OF EXCITATION-CONTRACTION COUPLING: Ca-SIGNALING AND MYOFILAMENT Ca-RESPONSE MATCHING ENERGY SUPPLY TO ENERGY DEMAND IN CARDIAC MYOCYTES CELLULAR MECHANISMS OF PRELOAD, AFTERLOAD, AND CONTRACTILITY TUNING OF CARDIAC FUNCTION TO HEMODYNAMIC DEMANDS PHOSPHORYLATION OF REGULATORY PROTEINS CONTROLS CARDIAC DYNAMICS AND CONTRACTILE STATE AT THE LEVEL OF THE MYOCYTES CELLULAR MECHANISMS CONTROLLING CARDIAC CONTRACTILITY AFTERLOAD REGULATES THE NUMBER OF CYCLING CROSS-BRIDGES ACCORDING TO THE FORCE–VELOCITY RELATION CELL LENGTH REGULATES THE NUMBER OF CYCLING CROSS-BRIDGES AS A RESULT OF CHANGES IN SARCOMERIC GEOMETRY AND Ca2+ ACTIVATION REFERENCES 50 Ventricular Mechanics INTRODUCTION STRUCTURE OF VENTRICULAR TISSUE MYOCYTE ORIENTATION LAMINAR ORGANIZATION OF MYOCARDIUM EXTRACELLULAR MATRIX THE CARDIAC CYCLE ELECTROMECHANICAL ACTIVATION CARDIAC CYCLE THE PRESSURE–VOLUME LOOP DETERMINANTS OF LEFT VENTRICULAR FILLING PRESSURE–VOLUME ANALYSIS MYOCARDIAL STIFFNESS MYOCYTE RELAXATION LEFT VENTRICLE TORSION AND RECOIL VENTRICULAR SUCTION ECHOCARDIOGRAPHIC MEASURES OF DIASTOLIC FUNCTION ATRIAL CONTRACTION DIASTOLIC DYSFUNCTION FROM MYOCARDIAL ISCHEMIA DIASTOLIC DYSFUNCTON FROM HYPERTROPHY SYSTOLIC FUNCTION AND END-SYSTOLIC ELASTANCE CARDIAC OUTPUT AND CARDIAC INDEX THE SWAN-GANZ CATHETER EJECTION FRACTION THE END-SYSTOLIC PRESSURE–VOLUME RELATIONSHIP SYSTOLIC DYSFUNCTION FROM MYOCARDIAL ISCHEMIA PUMP FUNCTION THE FRANK-STARLING RELATIONSHIP THE FORCE–FREQUENCY RELATIONSHIP NON-STARLING REGULATION OF BLOOD PRESSURE AND CARDIAC OUTPUT MYOCARDIAL ENERGY EXPENDITURE AND EFFICIENCY DETERMINANTS OF MYOCARDIAL ENERGY CONSUMPTION AFTERLOAD AND VENTRICULO-ARTERIAL COUPLING REGIONAL STRAIN IMPLANTED MARKERS ECHOCARDIOGRAPHY MAGNETIC RESONANCE IMAGING REGIONAL STRESS AND THE FINITE ELEMENT METHOD THE FINITE ELEMENT METHOD CALCULATION OF STRESS INVERSE CALCULATION OF MYOCARDIAL MATERIAL PARAMETERS VIRTUAL SURGERY MULTISCALE MODELING VENTRICULAR INTERACTION AND PERICARDIUM PERICARDIUM ACKNOWLEDGMENT REFERENCES 51 Blood Conservation, Transfusion, and Conservation INTRODUCTION NORMAL HEMOSTATIC MECHANISMS INHIBITING HEMOSTASIS: ANTICOAGULATION PARENTERAL AGENTS HEPARIN AND DERIVATIVES HEPARIN REVERSAL LOW-MOLECULAR-WEIGHT HEPARIN FONDAPARINUX DIRECT THROMBIN INHIBITORS ARGATROBAN BIVALIRUDIN ORAL ANTICOAGULANTS WARFARIN NON–VITAMIN K ORAL ANTICOAGULANTS FACTOR XA INHIBITORS APIXABAN RIVAROXABAN EDOXABAN DIRECT THROMBIN INHIBITORS DABIGATRAN REVERSAL OF NON–VITAMIN K ORAL ANTICOAGULANTS HEPARIN-INDUCED THROMBOCYTOPENIA AND DIRECT THROMBIN INHIBITORS ACQUIRED PLATELET DYSFUNCTION HEMOSTATIC TESTING RISK FACTORS FOR BLEEDING PATIENT-RELATED CAUSES OF BLEEDING PHYSICIAN-RELATED CAUSES OF BLEEDING PROCEDURE-RELATED CAUSES OF BLEEDING DRUG-RELATED CAUSES OF BLEEDING TRANSFUSION THERAPY AND TRANSFUSION GUIDELINES RED BLOOD CELLS PLASMA/FRESH FROZEN PLASMA FIBRINOGEN REPLACEMENT THERAPY FIBRINOGEN MASSIVE TRANSFUSION ADVERSE EFFECTS OF TRANSFUSIONS TRANSFUSION-RELATED ACUTE LUNG INJURY PATIENT BLOOD MANAGEMENT IN CARDIAC SURGERY OVERVIEW BLOOD CONSERVATION STRATEGIES PREOPERATIVE AUTOLOGOUS DONATION ACUTE NORMOVOLEMIC HEMODILUTION PLATELET PLASMAPHERESIS RED BLOOD CELL SCAVENGING TECHNIQUES PROHEMOSTATIC AGENTS USED IN SURGERY ANTIFIBRINOLYTIC AGENTS LYSINE ANALOGUES: ε-AMINOCAPROIC ACID AND TRANEXAMIC ACID DESMOPRESSIN RECOMBINANT FACTOR VIIa PROTHROMBIN COMPLEX CONCENTRATE TOPICAL HEMOSTATIC AGENTS SURGICAL APPROACH BLOOD CONSERVATION PROGRAMS BLEEDING MANAGEMENT ALGORITHMS SUMMARY References 52 Coronary Angiography: Valve and Hemodynamic Assessment DIAGNOSTIC CATHETERIZATION TECHNIQUES INDICATIONS CONTRAINDICATIONS COMPLICATIONS CORONARY ANGIOGRAPHY VASCULAR ACCESS FEMORAL ARTERY ACCESS RADIAL ARTERY ACCESS LEFT CORONARY ANGIOGRAPHY RIGHT CORONARY ANGIOGRAPHY CORONARY ANOMALIES ANGIOGRAPHIC PROJECTIONS LEFT MAIN CORONARY ARTERY LEFT ANTERIOR DESCENDING CORONARY ARTERY LEFT CIRCUMFLEX CORONARY ARTERY RIGHT CORONARY ARTERY BYPASS GRAFT ANGIOGRAPHY LESION STRUCTURAL AND FUNCTIONAL ASSESSMENT CORONARY PHYSIOLOGY FRACTIONAL FLOW RESERVE OTHER MODALITIES FOR EVALUATION OF CORONARY PHYSIOLOGY INTRAVASCULAR IMAGING INTRAVASCULAR ULTRASOUND VERSUS OPTICAL COHERENCE TOMOGRAPHY HEMODYNAMIC EVALUATION Principles RIGHT HEART CATHETERIZATION PRESSURE WAVEFORMS RIGHT ATRIUM RIGHT VENTRICLE PULMONARY ARTERY PULMONARY CAPILLARY WEDGE PRESSURE SYSTEMIC ARTERIAL PRESSURE CARDIAC OUTPUT SHUNTS LEFT-TO-RIGHT SHUNTS RIGHT-TO-LEFT SHUNTS BIDIRECTIONAL SHUNTS VASCULAR RESISTANCE VALVULAR HEART DISEASE AORTIC STENOSIS AORTIC REGURGITATION MITRAL STENOSIS MITRAL REGURGITATION PERICARDIAL DISEASE PERICARDITIS CARDIAC TAMPONADE CONSTRICTION–RESTRICTION CONCLUSION REFERENCES 53 Applications of Cardiovascular Magnetic Resonance and Computed Tomography in Cardiovascular Diagnosis IMAGING PRINCIPLES AND APPROACHES CHALLENGES OF CARDIAC IMAGING IMAGING COMPARISONS IMAGING PRECAUTIONS CLINICAL APPLICATIONS DISEASES OF THE THORACIC AORTA AORTIC ANEURYSM AORTIC DISSECTION AORTIC INTRAMURAL HEMATOMA SINUS OF VALSALVA ANEURYSM ATHEROSCLEROTIC PLAQUE AND AORTIC PENETRATING ULCER TAKAYASU ARTERITIS CONGENITAL AORTIC ANOMALIES THORACIC TRAUMA CARDIAC IMAGING VENTRICULAR STRUCTURE AND FUNCTION IDENTIFICATION OF MYOCARDIAL SCAR AND ISCHEMIA CARDIOMYOPATHIES VALVULAR HEART DISEASE CONGENITAL HEART DISEASE CARDIAC AND PARACARDIAC MASSES PERICARDIAL DISEASE CORONARY ARTERY IMAGING THE FUTURE ROLE OF CARDIOVASCULAR MAGNETIC RESONANCE AND CARDIOVASCULAR COMPUTED TOMOGRAPHY REFERENCES 54 Nuclear Cardiology and Positron Emission Tomography in the Assessment of Patients With Cardiovascular Disease INTRODUCTION TO NUCLEAR CARDIOLOGY GENERAL PRINCIPLES RADIOACTIVE TRACERS EQUIPMENT AND PROCEDURES STABLE CORONARY ARTERY DISEASE (DIAGNOSIS AND RISK STRATIFICATION) STRESS TESTING IN THE DETECTION OF CORONARY ARTERY DISEASE EXERCISE STRESS TESTING EXERCISE STRESS MYOCARDIAL PERFUSION IMAGING STRESS-ONLY IMAGING PHARMACOLOGIC STRESS MYOCARDIAL PERFUSION IMAGING PHARMACOLOGIC STRESS AND LOW-LEVEL EXERCISE COMBINATION PROGNOSIS AND RISK STRATIFICATION STABLE ANGINA MEDICAL THERAPY VERSUS REVASCULARIZATION ACUTE CORONARY SYNDROMES REST MYOCARDIAL PERFUSION IMAGING FOR ACUTE CORONARY SYNDROMES POST-MYOCARDIAL INFARCTION RISK STRATIFICATION ASSESSMENT OF MYOCARDIAL VIABILITY LEFT VENTRICULAR EJECTION FRACTION AND PROGNOSIS POSITRON EMISSION TOMOGRAPHY AND SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY IN DETERMINING MYOCARDIAL VIABILITY POSITRON EMISSION TOMOGRAPHY QUANTITATIVE METHODS SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY THALLIUM TECHNETIUM-LABELED TRACERS HYBRID IMAGING PROGNOSTIC IMPLICATIONS OF VIABILITY ASSESSMENT EVALUATION OF PATIENTS POST-REVASCULARIZATION INFLAMMATION CARDIAC AMYLOIDOSIS CARDIAC SARCOIDOSIS FUTURE DIRECTIONS References 55 Diagnostic Echocardiography (Ultrasound Imaging in Cardiovascular Diagnosis) BASIC PRINCIPLES ULTRASOUND IMAGING MODALITIES DOPPLER ECHOCARDIOGRAPHY Three-Dimensional Echocardiography VENTRICULAR FUNCTION SYSTOLIC FUNCTION DIASTOLIC FUNCTION ISCHEMIC HEART DISEASE STRESS TESTING FOR CORONARY ARTERY DISEASE COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION CARDIAC MASSES CARDIOMYOPATHIES CONGESTIVE HEART FAILURE HYPERTROPHIC AND RESTRICTIVE CARDIOMYOPATHY CARDIAC TRANSPLANTATION/VENTRICULAR ASSIST DEVICES PERICARDIAL AND CONSTRICTIVE HEART DISEASE VALVULAR HEART DISEASE AORTIC STENOSIS AORTIC REGURGITATION MITRAL STENOSIS MITRAL REGURGITATION TRICUSPID VALVE DISEASE PROSTHETIC VALVES ENDOCARDITIS AORTIC DISEASE CARDIAC POINT-OF-CARE ULTRASOUND PERIOPERATIVE AND INTERVENTIONAL ECHOCARDIOGRAPHY REFERENCES 56 Interventional Cardiology HISTORICAL PERSPECTIVE PERCUTANEOUS CORONARY INTERVENTION PROCEDURES PERCUTANEOUS CORONARY INTERVENTION FOR UNSTABLE ANGINA AND NON–ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION PERCUTANEOUS CORONARY INTERVENTION FOR ST-ELEVATION MYOCARDIAL INFARCTION PERCUTANEOUS CORONARY INTERVENTION FOR CHRONIC STABLE ANGINA MULTIVESSEL PERCUTANEOUS CORONARY INTERVENTION LEFT MAINSTEM DISEASE ELECTIVE PERCUTANEOUS CORONARY INTERVENTION AND NONCARDIAC SURGERY COMPLICATIONS OF PERCUTANEOUS CORONARY INTERVENTION DEATH EMERGENCY BYPASS SURGERY MYOCARDIAL INFARCTION VASCULAR COMPLICATIONS AND HEMORRHAGIC COMPLICATIONS CONTRAST-INDUCED NEPHROPATHY ANAPHYLACTOID REACTIONS RESTENOSIS ADVANCED TECHNOLOGY IN PERCUTANEOUS CORONARY INTERVENTION DRUG-ELUTING STENTS ATHERECTOMY AND LITHOTRIPSY DEVICES THROMBECTOMY AND DISTAL PROTECTION INTRAVASCULAR ULTRASOUND, OPTICAL COHERENCE TOMOGRAPHY, AND INTRAVASCULAR PHYSIOLOGY CATHETER-BASED THERAPY AFTER BYPASS HYBRID CORONARY REVASCULARIZATION PHARMACOLOGY SURGICAL CONSIDERATIONS FOR ANTICOAGULATION NONCORONARY INTERVENTIONAL CARDIAC PROCEDURES BALLOON MITRAL VALVULOPLASTY PERCUTANEOUS MITRAL VALVE REPAIR AND REPLACEMENT BALLOON AORTIC VALVULOPLASTY ALCOHOL SEPTAL ABLATION FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY CLOSURE OF PATENT FORAMEN OVALE AND ATRIAL SEPTAL DEFECT PERCUTANEOUS CIRCULATORY ASSIST DEVICES INTRA-AORTIC BALLOON PUMP PERCUTANEOUS LEFT VENTRICULAR ASSIST DEVICES PERCUTANEOUS RIGHT VENTRICULAR ASSIST DEVICES REFERENCES 57 Management of Acute Coronary Syndromes ACUTE CORONARY SYNDROME DEFINITION EPIDEMIOLOGY PATHOPHYSIOLOGY TYPE 1 VERSUS TYPE 2 MYOCARDIAL INFARACTION PLAQUE RUPTURE/EROSION CENTRAL ROLE OF PLATELETS ROLE OF INFLAMMATION DIAGNOSIS CLINICAL MANIFESTATIONS ELECTROCARDIOGRAPHY CARDIAC BIOMARKERS MANAGEMENT OF NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME INITIAL EVALUATION AND RISK STRATIFICATION PHARMACOLOGIC MANAGEMENT ANTI-ISCHEMIC THERAPY ANTIPLATELET THERAPY Aspirin Oral P2Y12 Inhibitors (Clopidogrel, Prasugrel, Ticagrelor) Intravenous P2Y12 Inhibitors (Cangrelor) GLYCOPROTEIN IIb/IIIa INHIBITORS ANTITHROMBOTIC THERAPY Unfractionated Heparin Low-Molecular-Weight Heparin Fondaparinux Bivalirudin Protease-Activated Receptor-1 Inhibitors (Vorapaxar) Oral Anticoagulants INVASIVE MANAGEMENT CONSIDERATIONS IN PATIENTS WITH NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME FROM SURGICAL STANDPOINT MANAGEMENT OF MULTIVESSEL CORONARY ARTERY DISEASE ST-ELEMENT ELEVATION MYOCARDIAL INFARCTION DEFINITION RISK ASSESSMENT SELECTING A REPERFUSION THERAPY PRIMARY PERCUTANEOUS CORONARY INTERVENTION FIBRINOLYTIC THERAPY RESCUE PERCUTANEOUS CORONARY INTERVENTION TRANSFER FOR ROUTINE EARLY CORONARY ANGIOGRAPHY AFTER FIBRINOLYSIS FACILITATED PERCUTANEOUS CORONARY INTERVENTION DELAYED INVASIVE MANAGEMENT CORONARY ARTERY BYPASS GRAFT SURGERY IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION ADDITIONAL CONSIDERATIONS IN ACUTE CORONARY SYNDROME MANAGEMENT RADIAL ACCESS FOR PERCUTANEOUS CORONARY INTERVENTION CARDIOGENIC SHOCK POST-REVASCULARIZATION THERAPY CARDIAC REHABILITATION SECONDARY PREVENTION CONCLUSION REFERENCES 58 The Pharmacologic Management of Heart Failure PATHOPHYSIOLOGY OF HEART FAILURE ACUTE HEART FAILURE CHRONIC HEART FAILURE PHARMACOLOGIC AGENTS USED IN THE TREATMENT OF HEART FAILURE RENIN-ANGIOTENSIN SYSTEM INHIBITORS ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ANGIOTENSIN RECEPTOR BLOCKING AGENTS ANGIOTENSIN RECEPTOR-NEPRILYSIN INHIBITORS β-ADRENERGIC BLOCKING AGENTS MINERALOCORTICOID RECEPTOR ANTAGONISTS SPIRONOLACTONE AND EPLERENONE DIURETICS INOTROPIC AGENTS DIGOXIN DOPAMINE DOBUTAMINE PHOSPHODIESTERASE INHIBITORS VASODILATORS NITROVASODILATORS HYDRALAZINE CALCIUM CHANNEL BLOCKING AGENTS NATRIURETIC PEPTIDES IVABRADINE SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITORS APPROACH TO THE MANAGEMENT OF HEART FAILURE INITIAL APPROACH AND CLINICAL ASSESSMENT TREATMENT OF ACUTE DECOMPENSATED SYSTOLIC HEART FAILURE FLASH PULMONARY EDEMA TREATMENT OF CHRONIC COMPENSATED SYSTOLIC HEART FAILURE CARDIAC RESYNCHRONIZATION THERAPY IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR TREATMENT OF DIASTOLIC HEART FAILURE PERIOPERATIVE HEART FAILURE SUGGESTED READING 59 Transcatheter Aortic Valve Replacement INTRODUCTION INDICATIONS PREOPERATIVE EVALUATION AND PLANNING AORTIC VALVE AND CARDIAC ASSESSMENT LOWER EXTREMITY ASSESSMENT OTHER COMORBIDITY ASSESSMENT ALTERNATIVE ACCESS CONSIDERATIONS OPERATIVE TECHNIQUES TRANSFEMORAL TRANSCATHETER AORTIC VALVE REPLACEMENT TRANSCAVAL TRANSCAROTID TRANSCATHETER AORTIC VALVE REPLACEMENT TRANSSUBCLAVIAN/AXILLARY TRANSAORTIC TRANSCATHETER AORTIC VALVE REPLACEMENT TRANSAPICAL TRANSCATHETER AORTIC VALVE REPLACEMENT RESULTS HIGH-RISK AND INOPERABLE PATIENTS INTERMEDIATE- AND LOW-RISK PATIENTS OTHER SPECIFIC COMPLICATIONS CONDUCTION ABNORMALITIES PARAVALVULAR REGURGITATION CORONARY OBSTRUCTION POPULATION SUBGROUPS AND AREAS OF UNCERTAINTY YOUNG PATIENTS BICUSPID AORTIC VALVES CONCOMITANT CORONARY ARTERY DISEASE VALVE-IN-VALVE TRANSCATHETER AORTIC VALVE REPLACEMENT CONCLUSION REFERENCES 60 Transcatheter Treatment of Mitral and Tricuspid Valve Disease INTRODUCTION MITRAL REGURGITATION TRICUSPID REGURGITATION Transcatheter Valve Interventions TRANSCATHETER MITRAL VALVE REPAIR TRANSCATHETER EDGE-TO-EDGE REPAIR DEVICES TRANSCATHETER EDGE-TO-EDGE REPAIR: LANDMARK TRIALS TRANSCATHETER EDGE-TO-EDGE REPAIR: REAL WORLD OUTCOMES OTHER TRANSCATHETER MITRAL VALVE REPAIR DEVICES FUTURE OF TRANSCATHETER MITRAL VALVE REPAIR TRANSCATHETER MITRAL VALVE REPLACEMENT VALVE-IN-VALVE AND VALVE-IN-RING REPLACEMENT VALVE-IN-MITRAL ANNULAR CALCIFICATION NATIVE TRANSCATHETER MITRAL VALVE REPLACEMENT TRANSCATHETER TRICUSPID VALVE INTERVENTIONS OUTCOMES OF ISOLATED TRICUSPID VALVE SURGERY ETIOLOGY OF TRICUSPID DISEASE PREPROCEDURAL EVALUATION TRANSCATHETER TRICUSPID VALVE THERAPIES TRICUSPID VALVE LEAFLET COAPTATION DEVICES EDGE-TO-EDGE REPAIR PASCAL FORMA MISTRAL DEVICES IN PRECLINICAL STUDIES ANNULOPLASTY DEVICES TRIALIGN TRICINCH CARDIOBAND TRI-RING DEVICES IN PRECLINICAL DEVELOPMENT ORTHOTOPIC VALVE REPLACEMENT EVOQUE INTREPID SAPIEN VALVES TRISOL VALVE ADDITIONAL DEVICES UNDERGOING PRECLINICAL INVESTIGATION HETEROTOPIC VALVE REPLACEMENT SAPIEN VALVES TRICVALVE ADDITIONAL DEVICES FUTURE OF TRANSCATHETER TRICUSPID VALVE INTERVENTIONS References 61 Anesthesia and Intraoperative Care of the Adult Cardiac Surgical Patient Preoperative Evaluation Indications For Cardiac Surgery Identification And Optimization Of Risk Factors Information Relevant For Selecting Appropriate Monitoring Modalities And Management Techniques Intraoperative Management Monitoring Choice Of Anesthetic Agents Fast-Track Cardiac Surgery/Enhanced Recovery After Surgery Regional Anesthesia And Analgesia Intraoperative Blood Glucose Control Acid-Base Management During Hypothermia Anticoagulation For Cardiopulmonary Bypass Use Of Antifibrinolytics Cerebral Protection Hemodynamic Support On Separation From Cardiopulmonary Bypass Special Considerations Off-Pump Coronary Artery Bypass Minimally Invasive Cardiac Surgery Hybrid Cardiac Surgery Robotic-Assisted Cardiac Surgery References 62 Critical Care for the Adult Cardiac Patient IMMEDIATE POSTOPERATIVE CARE MULTIDISCIPLINARY PERIOPERATIVE HANDOFF SYSTEMATIC EXAMINATION AND EVALUATION AIRWAY AND VENTILATION Neurologic Examination CARDIAC AUSCULTATION, ELECTROCARDIOGRAM, AND ARRHYTHMIAS ABDOMINAL AND GENITOURINARY EXAMINATION PERIPHERAL PERFUSION BODY TEMPERATURE HEMODYNAMICS LINES, TUBES, DEVICES, AND DRESSINGS CHEST RADIOGRAPH PAIN MANAGEMENT ENHANCED RECOVERY AFTER SURGERY CARDIAC DYSFUNCTION AFTER CARDIAC SURGERY LOW CARDIAC OUTPUT SYNDROME OUTPUT AND FILLING PRESSURE OXYGEN DELIVERY ACID-BASE IMBALANCE PRELOAD AFTERLOAD POSTOPERATIVE HYPERTENSION POSTOPERATIVE VASOPLEGIA HEART RATE INOTROPIC SUPPORT MECHANICAL CIRCULATORY SUPPORT CARDIAC TAMPONADE RIGHT HEART DYSFUNCTION ARRHYTHMIAS ATRIAL FLUTTER ATRIAL FIBRILLATION Incidence and Risk Diagnosis and Treatment VENTRICULAR ARRHYTHMIAS ECHOCARDIOGRAPHY AND ADVANCED MONITORING POSTOPERATIVE BLEEDING COAGULOPATHY HEPARIN EFFECT THROMBOCYTOPENIA THROMBASTHENIA SPECIFIC FACTOR DEFICIENCIES MANAGEMENT OF BLEEDING CRYSTALLOID AND COLLOID VOLUME RESUSCITATION BLOOD CONSERVATION PHARMACOLOGIC CONSIDERATIONS DESMOPRESSIN ε-Aminocaproic Acid and Tranexamic Acid RECOMBINANT ACTIVATED FACTOR VII NEUROLOGIC COMPLICATIONS INFECTION SPECIFIC CONSIDERATIONS AFTER CARDIAC SURGERY POSTPERICARDIOTOMY SYNDROME GRAFT OCCLUSION AFTER CORONARY ARTERY BYPASS REFERENCES 63 Critical Care for War-Related Thoracic Injuries A BRIEF HISTORY OF WAR-RELATED CHEST WOUNDS MODERN PRINCIPLES OF COMBAT CASUALTY CARE DEPARTMENT OF DEFENSE TRAUMA SYSTEM SURGICAL EXPERTISE IN COMBAT HEMORRHAGE CONTROL AND CRITICAL CARE EN-ROUTE CARE MANAGEMENT OF COMBAT THORACIC TRAUMA INITIAL EVALUATION DAMAGE CONTROL RESUSCITATION AND DAMAGE CONTROL SURGERY PHASE 0 PHASE 1 PHASE 2 PHASE 3 ICU MANAGEMENT AND CRITICAL CARE TRANSPORT SPECIFIC THORACIC INJURIES EXPLOSIVE INJURY PNEUMOTHORAX AND HEMOTHORAX CHEST WALL DEFECTS AND FLAIL CHEST AORTIC AND GREAT VESSEL INJURIES LUNG PARENCHYMA OR HILUM INJURIES CARDIAC TAMPONADE AND CARDIAC INJURIES ESOPHAGEAL INJURIES TRACHEOBRONCHIAL INJURIES DIAPHRAGM INJURIES LONG-TERM OUTCOMES SUMMARY References 64 Neurocognitive Deficits and Stroke Evaluation Populations At Risk Mechanisms Of Injury Strategies For Intraoperative Reduction Of Injury Neuroprotective Strategies Prognosis References 65 Cardiopulmonary Bypass: Technique and Pathophysiology Introduction And History Of Cardiopulmonary Bypass Technical Aspects Of Cardiopulmonary Bypass Device Overview Principles Of Current Oxygenator Design And Function Hypothermia And Acid-Base Balance Hematocrit And Priming Blood Conservation During Cardiopulmonary Bypass Flow Rates, Perfusion Pressure, And Autoregulation Pumps For Cardiopulmonary Bypass Cardiotomy Cardiac Venting For Cardiopulmonary Bypass Cannulation For Cardiopulmonary Bypass Venous Cannulation Arterial Cannulation Pathophysiology Of Cardiopulmonary Bypass Noncellular Response Cellular Activation During Cardiopulmonary Bypass: Platelets, Endothelial Cells, Leukocytes Nonbiomaterial-Related Activation During Cardiopulmonary Bypass Heparin–Protamine Axis Heparin: Pharmacology, Dosage, And Complications Protamine: Pharmacology, Complications Biomembrane Mimicry Heparin-Coated Circuits Surfaces With Modified Protein Adsorption Pharmacologic And HEMATOLOGIC Adjuncts To Minimize The Consequences Of Cardiopulmonary Bypass Biomaterial-Dependent Strategies To Minimize Blood Activation From Cardiopulmonary Bypass Organ Derangements Related To Cardiopulmonary Bypass Neuroendocrine Response To Cardiopulmonary Bypass Central Nervous System Injury With Cardiopulmonary Bypass Pulmonary Dysfunction With Cardiopulmonary Bypass Renal Dysfunction With Cardiopulmonary Bypass The Future Of Cardiopulmonary Bypass References 66 Extracorporeal Membrane Oxygenation INTRODUCTION HISTORY AND EVOLUTION PRINCIPLES OF EXTRACORPOREAL MEMBRANE OXYGENATION Veno-Arterial Extracorporeal Membrane Oxygenation Veno-Venous Extracorporeal Membrane Oxygenation CIRCUIT AND COMPONENTS INDICATIONS Veno-Arterial Extracorporeal Membrane Oxygenation—Indications Veno-Venous Extracorporeal Membrane Oxygenation—Indications CONTRAINDICATIONS CANNULATION STRATEGIES MANAGEMENT OF EXTRACORPOREAL MEMBRANE OXYGENATION COMMON PITFALLS COMPLICATIONS WEANING FROM EXTRACORPOREAL MEMBRANE OXYGENATION CONCLUSIONS REFERENCES 67 Deep Sternal Wound Infection INTRODUCTION INCIDENCE AND ETIOLOGY RISK FACTORS PREOPERATIVE RISK FACTORS PERIOPERATIVE RISK FACTORS POSTOPERATIVE RISK FACTORS DIAGNOSIS PREVENTION SURGICAL MANAGEMENT VACUUM-ASSISTED CLOSURE THERAPY PRIMARY CLOSURE AND IRRIGATION SOFT TISSUE FLAPS PECTORALIS MAJOR MUSCULAR FLAPS RECTUS ABDOMINIS MUSCULAR FLAPS OMENTAL FLAPS Fixation BIOLOGICAL MEMBRANE TREATMENT ALGORITHM CONCLUSION REFERENCES 68 Myocardial Protection INTRODUCTION HISTORICAL DEVELOPMENT FIBRILLATORY ARREST CONTINUOUS CORONARY PERFUSION HYPOTHERMIA REINTRODUCTION OF CARDIOPLEGIA BIOLOGY OF SURGICALLY INDUCED MYOCARDIAL ISCHEMIA MYOCARDIAL OXYGEN CONSUMPTION BIOCHEMICAL ALTERATIONS ISCHEMIA-REPERFUSION INJURY IRREVERSIBLE CELL INJURY INFLAMMATION EFFECTS OF AGE CYANOSIS VENTRICULAR HYPERTROPHY CARDIOPLEGIA: BASIC PRINCIPLES RAPID CARDIAC ARREST HYPOTHERMIA BUFFERING OF THE CARDIOPLEGIC SOLUTION AVOIDANCE OF MYOCARDIAL EDEMA ALTERNATIVE ARRESTING AGENTS AND ADDITIVES β-BLOCKERS AGENTS AFFECTING CALCIUM TRANSPORT METABOLIC SUBSTRATES CRYSTALLOID (ACELLULAR) AND BLOOD CARDIOPLEGIA CRYSTALLOID CARDIOPLEGIA BLOOD CARDIOPLEGIA METHODOLOGIES CARDIOPLEGIA TEMPERATURE DELIVERY SYSTEMS POTENTIAL NEW TECHNOLOGIES ISCHEMIC PRECONDITIONING REMOTE PRECONDITIONING POSTCONDITIONING References 69 Clinical Quality and Safety in Adult Cardiac Surgery National Landscape For Quality And Safety Evolving Landscape Of Quality And Safety In Cardiac Surgery Cardiac Surgery Teamwork And Communication Perioperative Care Preprocedure Verification, Marking, Time-Out, And Briefing Antibiotic Administration Preoperative Beta Blockade Postoperative Glucose Control Postoperative Morbidity Ventilator-Associated Pneumonia Central Line Infections Deep Sternal Wound Infections Response To Changes In A Patient’s Condition Medication Safety And Reconciliation Active Involvement Of Patients In Their Own Care Communication Among Caregivers Measurement Of Care Enhanced Recovery After Surgery In Cardiac Surgery Preoperative Strategies Intraoperative Strategies Postoperative Strategies Secondary Prevention After Cardiac Surgery Conclusion References 70 Surgery of the Aortic Root and Ascending Aorta FUNCTIONAL ANATOMY OF THE AORTIC ROOT PATHOLOGY OF THE AORTIC ROOT AND ASCENDING AORTA DEGENERATIVE ANEURYSMS OF THE PROXIMAL AORTA INHERITED ANEURYSMS OF THE PROXIMAL AORTA MARFAN SYNDROME LOEYS-DIETZ SYNDROME EHLERS-DANLOS SYNDROME BICUSPID AORTIC VALVE DISEASE ATHEROSCLEROSIS PORCELAIN AORTA INFECTIOUS ANEURYSMS AORTITIS AORTIC DISSECTION ASCENDING AORTA TUMORS ASCENDING AORTA TRAUMA SURGICAL TREATMENT OF ASCENDING AORTIC ANEURYSM OPERATIVE TECHNIQUES CLINICAL OUTCOMES SURGICAL TREATMENT OF AORTIC ROOT ANEURYSMS OPERATIVE TECHNIQUES REMODELING OF THE AORTIC ROOT REIMPLANTATION OF THE AORTIC VALVE OTHER TYPES OF AORTIC VALVE–SPARING OPERATIONS AORTIC ROOT REPLACEMENT CLINICAL OUTCOMES ROSS PROCEDURE OPERATIVE TECHNIQUES SUBCORONARY IMPLANTATION AORTIC ROOT REPLACEMENT AORTIC ROOT INCLUSION Inclusion Into a Dacron Graft CLINICAL OUTCOMES REFERENCES 71 Surgery of the Aortic Arch Definitions And ClassificationS Causative And Predisposing Factors Congenital Aneurysms Medial Degenerative Aneurysms Aortic Dissection Mycotic Aneurysms Vasculitis And Aortitis Trauma Tumors Of The Arch Reoperations Syndromes Associated With Aortic Arch Pathology History And Physical Examination Preoperative Studies Cardiopulmonary Perfusion Aspects Brain Protection Primum Non Nocere: First, Do No Harm Prevention Of Stroke Prevention Of Neurocognitive Deficits Operative Techniques Hemiarch Replacement Replacement Of The Entire Aortic Arch Frozen Elephant Trunk Modification Other Techniques Outcomes Summary References 72 Descending Thoracic and Thoracoabdominal Aortic Surgery INTRODUCTION EVOLUTION OF AORTIC SURGERY EPIDEMIOLOGY POPULATION AND RISK FACTORS PATHOLOGY AND ETIOLOGY THE NORMAL AORTA ANEURYSM FORMATION CHRONIC AORTIC DISSECTION HEREDITARY DISORDERS AORTITIS MYCOTIC ANEURYSM ANEURYSM AFTER PREVIOUS OPEN AORTIC REPAIR ANEURYSM AFTER PREVIOUS ENDOVASCULAR AORTIC REPAIR COARCTATION IN THE ADULT NATURAL HISTORY CLINICAL MANIFESTATIONS SYMPTOMS DIAGNOSIS IMAGING ANEURYSM CLASSIFICATION NONOPERATIVE MANAGEMENT SURGICAL TREATMENT INDICATIONS FOR REPAIR CONTRAINDICATIONS TO REPAIR TYPES OF REPAIR PREOPERATIVE EVALUATION ASSESSMENT OF CRITICAL ORGAN FUNCTIONS MULTIMODAL STRATEGY BASED ON EXTENT OF REPAIR LEFT HEART BYPASS VISCERAL PROTECTION SPINAL CORD PROTECTION RENAL PROTECTION HYPOTHERMIA PREOPERATIVE EVALUATION OF IMAGING STUDIES PREOPERATIVE PREPARATION ANESTHESIA OPERATIVE TECHNIQUE POSITIONING INCISION AND EXPOSURE AORTIC REPAIR CANNULATION AND PERFUSION SETUP FOR LEFT HEART BYPASS PLACEMENT OF AORTIC CROSS-CLAMP AND AORTIC REPAIR HEMOSTASIS AND REWARMING CLOSURE SPECIAL SITUATIONS ELEPHANT TRUNK APPROACHES TECHNIQUES IN REOPERATIONS AFTER PRIMARY REPAIR OPEN REPAIR AFTER ENDOVASCULAR AORTIC REPAIR POSTOPERATIVE MANAGEMENT IMMEDIATE POSTOPERATIVE MANAGEMENT LONG-TERM MANAGEMENT OUTCOMES OUTCOMES OF DESCENDING THORACIC AORTIC ANEURYSM REPAIR OUTCOMES OF THORACOABDOMINAL AORTIC ANEURYSM REPAIR COMPARISON OF OPEN SURGERY AND ENDOVASCULAR REPAIR CONCLUSION ACKNOWLEDGMENTS FUNDING REFERENCES 73 Type A Aortic Dissection HISTORICAL NOTES CLASSIFICATION EPIDEMIOLOGY NATURAL HISTORY PREDISPOSING FACTORS HYPERTENSION HERITABLE OR FAMILIAL AORTIC DISEASE AND CONNECTIVE TISSUE DISORDERS CONGENITAL CARDIOVASCULAR ABNORMALITIES IATROGENIC INJURY PREGNANCY ILLICIT DRUG-RELATED DISSECTIONS OTHER ASSOCIATIONS PATHOPHYSIOLOGY AND PATHOLOGIC FINDINGS MEDIAL DEGENERATION PRIMARY INTIMAL TEAR PROPAGATION AND REENTRY INTRAMURAL HEMATOMA AORTIC BRANCH COMPROMISE CLINICAL MANIFESTATIONS PATIENT CHARACTERISTICS ACUTE TYPE A DISSECTION PAIN SYSTEMIC MANIFESTATIONS CARDIOVASCULAR MANIFESTATIONS PERIPHERAL VASCULAR COMPLICATIONS Cerebrovascular Complications and Stroke CHRONIC TYPE A DISSECTION DIAGNOSTIC METHODS AORTOGRAPHY COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING ECHOCARDIOGRAPHY DIAGNOSTIC STRATEGY AND SPECIAL DIAGNOSTIC CONSIDERATIONS INTRAMURAL HEMATOMA CORONARY ANGIOGRAPHY BIOMARKERS SURGICAL MANAGEMENT ACUTE TYPE A DISSECTION PATIENT TRIAGE, RISK OF TRANSFER, AND REGIONALIZATION OF SURGICAL CARE FOR PATIENTS WITH ACUTE TYPE A AORTIC DISSECTION SURGICAL PRINCIPLES AND OPERATIVE APPROACHES TECHNICAL CONSIDERATIONS CHOICE OF ARTERIAL CANNULATION SITE AND BRAIN PROTECTION METHODS OPERATIVE TECHNIQUE MORE RADICAL MANAGEMENT OF THE AORTIC ROOT MANAGEMENT OF THE AORTIC ARCH AND DOWNSTREAM THORACOABDOMINAL AORTA SPECIAL SITUATIONS Primary Intimal Tear in the Descending Thoracic Aorta (Retro-A Dissection) Type A Aortic Dissection and Coarctation Postoperative Malperfusion RESULTS SURVIVAL REOPERATION CHRONIC TYPE A AORTIC DISSECTION INDICATIONS FOR OPERATIVE INTERVENTION FOR CHRONIC TYPE A DISSECTION SURGICAL TECHNIQUE: CHRONIC TYPE A DISSECTION RESULTS OF SURGICAL TREATMENT—CHRONIC TYPE A DISSECTION FOLLOW-UP REFERENCES 74 Type B Aortic Dissection HISTORICAL NOTE CLASSIFICATION SYSTEMS EPIDEMIOLOGY AND NATURAL HISTORY Epidemiology Natural History PATHOPHYSIOLOGY CLINICAL MANIFESTATIONS DIAGNOSTIC MODALITIES MANAGEMENT Strategy Initial Medical Treatment (OMT) Definitive Long-term Medical Management OPERATIVE APPROACH Acute Type B Dissections Open Surgical Approach Management of Peripheral Vascular Complications Debate Between TEVAR, OMT, and Open Surgical Graft Replacement Chronic Type B Dissections RESULTS Comparison of Results of Surgical and Medical Treatment Historical Perspective Comparative Studies of Surgical versus Medical versus TEVAR Treatment Newer Results Early Survival Late Survival Aortic Reintervention CLOSE FOLLOW-UP IS CRUCIAL REFERENCES 75 Treatment of Acute and Late Complications of Aortic Dissection INTRODUCTION CLASSIFICATION OF AORTIC DISSECTION ACUTE COMPLICATIONS OF AORTIC DISSECTION RUPTURE MALPERFUSION STATIC VERSUS DYNAMIC OBSTRUCTION MESENTERIC RENAL LIMB ISCHEMIA SPINAL CORD ISCHEMIA CEREBRAL TECHNICAL CONSIDERATIONS FOR THORACIC ENDOVASCULAR AORTIC REPAIR IN AORTIC DISSECTION RETROGRADE TYPE A DISSECTION AFTER THORACIC ENDOVASCULAR AORTIC REPAIR SURVEILLANCE FOR CHRONIC COMPLICATIONS OF AORTIC DISSECTION REFERENCES 76 Endovascular Therapy for Thoracic Aortic Pathologies BACKGROUND ANATOMIC AND TECHNICAL CONSIDERATIONS ACCESS LANDING ZONES SUPRA-AORTIC BYPASSES TO AUGMENT LANDING ZONE SELECT, COMMERCIALmLY AVAILABLE DEVICES GORE TAG Cook Zenith TX2/Dissection Thoracic Prostheses Bolton Relay Prosthesis (Terumo Aortic) DESCENDING THORACIC AORTIC ANEURYSMS NATURAL HISTORY AND INDICATIONS FOR INTERVENTION RESULTS AORTIC DISSECTIONS CLASSIFICATION INDICATIONS FOR INTERVENTION ANATOMIC AND TECHNICAL CONSIDERATIONS RESULTS COMPLICATED TYPE B AORTIC DISSECTIONS UNCOMPLICATED TYPE B AORTIC DISSECTIONS MISCELLANEOUS ACUTE AORTIC SYNDROMES INTRAMURAL HEMATOMA AND PENETRATING ATHEROSCLEROTIC ULCERS BLUNT AORTIC INJURY COMPLICATIONS VASCULAR ACCESS ENDOLEAK AND PERSISTENT FALSE LUMEN FLOW NEUROLOGIC COMPLICATIONS AND RESCUE EMERGING TECHNOLOGIES HYBRID AND ENDOVASCULAR ARCH RECONSTRUCTION ASCENDING AORTIC STENT GRAFTS SUMMARY REFERENCES 77 Occlusive Disease of the Brachiocephalic Vessels and Management of Simultaneous Surgical Carotid/Coronary Disease INTRODUCTION OCCLUSIVE DISEASE INVOLVING THE BRACHIOCEPHALIC ARTERIES PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSTIC EVALUATION CONVENTIONAL IMAGING MODALITIES ULTRASONOGRAPHY AND EMERGING IMAGING MODALITIES ANATOMIC CONSIDERATIONS IN OPERATIVE EXPOSURES OF BRACHIOCEPHALIC VESSELS TREATMENT INNOMINATE ARTERY OCCLUSIVE DISEASE COMMON CAROTID ARTERY OCCLUSIVE DISEASE SUBCLAVIAN ARTERY OCCLUSIVE DISEASE MULTIVESSEL OCCLUSIVE DISEASE TAKAYASU ARTERITIS CORONARY-SUBCLAVIAN STEAL SYNDROME CONCURRENT CAROTID AND CORONARY ARTERY ATHEROSCLEROSIS OVERVIEW RISK FACTORS FOR STROKE AFTER CARDIAC SURGERY SURGICAL APPROACHES TO CONCURRENT CAROTID AND CORONARY DISEASE SYNCHRONOUS CAROTID ENDARTERECTOMY AND CORONARY ARTERY BYPASS GRAFTING STAGED APPROACH: CAROTID ENDARTERECTOMY FOLLOWED BY CORONARY ARTERY BYPASS GRAFTING REVERSE-STAGED APPROACH: CORONARY ARTERY BYPASS GRAFTING FOLLOWED BY CAROTID ENDARTERECTOMY CAROTID ARTERY STENTING FOLLOWED BY CORONARY ARTERY BYPASS GRAFTING SYNCHRONOUS OFF-PUMP CORONARY ARTERY BYPASS GRAFTING AND CAROTID ENDARTERECTOMY SUMMARY ACKNOWLEDGMENTS REFERENCES 78 Percutaneous Intervention on Abdominal and Peripheral Artery Disease PERIPHERAL ANGIOGRAPHY OVERVIEW INTRODUCTION TO CONVENTIONAL ANGIOGRAPHY RELATIVE CONTRAINDICATIONS GENERAL CONSIDERATIONS COMPLICATIONS CARBON DIOXIDE ANGIOGRAPHY INTRAVASCULAR ULTRASOUND ARTERIAL ACCESS INDICATIONS FOR CONVENTIONAL DIAGNOSTIC ANGIOGRAPHY HEAD, NECK, AND UPPER EXTREMITY ANGIOGRAPHY AORTIC ARCH ANGIOGRAPHY CEREBRAL ANGIOGRAPHY UPPER EXTREMITY ANGIOGRAPHY THORACIC AORTA ANGIOGRAPHY ABDOMINAL AORTA AND VISCERAL ARTERY ANGIOGRAPHY LOWER EXTREMITY ANGIOGRAPHY AORTOILIAC AND INFRAINGUINAL VESSELS PERCUTANEOUS INTERVENTION STRATEGIES AND SUPPORTING EVIDENCE HEAD AND NECK VESSELS UPPER EXTREMITY THORACIC AND ABDOMINAL AORTA AORTOILIAC VISCERAL ARTERIES LOWER EXTREMITY INFRAINGUINAL REFERENCES 79 Injury to the Heart and Great Vessels Blunt Cardiac Injury Historical Perspective Mechanism, Pathophysiology, and Incidence Clinical Presentation Diagnosis Of Blunt Cardiac Injury Can Be Challenging Electrocardiography Cardiac Enzymes And Troponins Two-Dimensional Transthoracic And Transesophageal Echocardiography Radionuclide Scans Spectrum Of Blunt Cardiac Injury: Assessment and Management Pericardial Injury Valvular, Papillary Muscle, Chordae Tendinea, and Septal Injury Blunt Coronary Artery Injury Cardiac Chamber Rupture Myocardial Contusion Conclusion Penetrating Cardiac Injury Historical Perspective Incidence Etiology Clinical Presentation Diagnosis Subxyphoid Pericardial Window Two-Dimensional Echocardiography Management Techniques For Cardiac Injury Repair Incisions Adjunct Maneuvers Repair Of Atrial Injuries Repair Of Ventricular Injuries Coronary Artery Injuries Complex and Combined Injuries Conclusion Thoracic Aorta and Arch Vessel Injuries Mechanisms and Types Of Injury Natural History Diagnosis Assessment And Management Ascending Aorta and Arch Vessel Injuries Descending Thoracic Aortic Injuries Innominate And Arch Vessel Injuries Conclusion References 80 Valve Replacement Therapy: History, Valve Types, and Options The Ideal Valve History Morbidity And Mortality Guidelines For Valve Operations Prosthetic Heart Valves Mechanical Valves Bileaflet Prostheses Medtronic Abbott Laboratories CORCYM On-X Life Technologies Bioprosthetic Valves Stented Porcine Bioprostheses Medtronic Abbott Laboratories Stented Bovine Pericardial Bioprostheses Edwards Lifesciences Medtronic CORCYM Abbott Laboratories Stentless Bioprostheses Medtronic Sutureless Valves CORCYM Edwards Lifesciences Transcatheter Valves Homograft Valve Replacement Choice Of Valve Replacement References 81 Surgical Treatment of Aortic Valve Disease Functional Anatomy Of The Aortic Valve Aortic Stenosis Epidemiology And Etiology Pathophysiology Clinical Features Diagnosis And Grading Natural History Indications For Surgery Aortic Regurgitation Aortic Valve Replacement Operative Techniques Aortic Root Enlargement Nicks-Nunez Technique Rittenhouse-MANOUGUIAN Technique Konno-Rastan Technique Special Considerations Of Postoperative Care Outcomes Early Mortality Long-Term Survival Early Complications Neurologic Complications Heart Block And Permanent Pacemaker Implantation Late Complications Thromboembolism, Anticoagulation, And Bleeding Complications Prosthetic Valve Endocarditis Structural Valve Deterioration And Freedom From Reoperation Paravalvular Leak And Hemolysis Symptomatic Relief Left Ventricular Remodeling Prosthesis-Patient Mismatch REFERENCES 82 Aortic Valve Repair INTRODUCTION AORTIC REGURGITATION Epidemiology and Etiology PATHOPHYSIOLOGY CLINICAL FEATURES DIAGNOSTIC CRITERIA INDICATIONS FOR SURGERY AORTIC VALVE ANATOMY AND FUNCTION CLASSIFICATION OF AORTIC INSUFFICIENCY SURGICAL TECHNIQUES EXPOSURE AND ASSESSMENT INTERVENTIONS ON THE AORTIC ROOT AND ANNULUS Subcommissural ANNULOPLASTY VALVE-SPARING ROOT REPLACEMENT—REIMPLANTATION TECHNIQUE ALTERNATIVE APPROACHES TO AORTIC VALVE ANNULOPLASTY CUSP REPAIR TECHNIQUES FREE MARGIN PLICATION FREE MARGIN RESUSPENSION CUSP SHAVING, RESECTION, AND PATCH USE BICUSPID AORTIC VALVE REPAIR UNICUSPID AND QUADRICUSPID AORTIC VALVES INTRAOPERATIVE ECHOCARDIOGRAPHY OUTCOMES OVERALL VALVE-SPARING AORTIC REPLACEMENT BICUSPID AORTIC VALVE REPAIR TRILEAFLET AORTIC VALVE REPAIR VALVE-RELATED COMPLICATIONS CONCLUSIONS REFERENCES 83 Surgical Treatment of Mitral Valve Disease Anatomy Annulus Leaflets Chordae Tendineae Papillary Muscles And Left Ventricular Wall Mitral Stenosis Pathophysiology Etiology Clinical Characteristics And Diagnosis Natural History Indications For Surgery Mitral Regurgitation Pathophysiology Functional Classification Etiology Degenerative Disease Rheumatic Disease Mitral Annular Calcification Infective Endocarditis Ischemic Cardiomyopathy Dilated Cardiomyopathy And Submitral Left Ventricular Aneurysms Clinical Characteristics And Diagnosis Chronic Acute Natural History Degenerative Disease Ischemic Cardiomyopathy Rheumatic Disease Infective Endocarditis Indications For Surgery Symptoms Left Ventricular Dysfunction And Enlargement Atrial Fibrillation And Pulmonary Hypertension Reparability Surgery Anesthesia And Monitoring Surgical Approaches Median Sternotomy Minimally Invasive Approaches Myocardial Management Operative Sequence In Context Of Concomitant Procedures Exposure Of The Mitral Valve Interatrial Approach Through Sondergaard’s Groove Right Atrial Trans-Septal Approach Left Atrial Dome Approach Open Commissurotomy Mitral Valve Repair Transesophageal Echocardiography Fundamentals Of Reconstructive Surgery Valve Analysis Remodeling Ring Annuloplasty Assessment of Repair Valve Repair In Type I Dysfunction Valve Repair In Type Ii Dysfunction Posterior Leaflet Prolapse Quadrangular Resection With or Without Sliding Plasty and Triangular Resection. Multisegmental Prolapse. Posterior Ventricular Anchoring Neochordal Remodeling Repair. Anterior Leaflet Prolapse Triangular Resection. Chordal Transposition. Artificial Neochordae. Double-Orifice Edge-to-Edge Repair. Commissural Prolapse Valve Repair In Type Iiia Dysfunction Valve Repair In Type Iiib Dysfunction Annular Decalcification And Annular Reconstruction Considerations In Endocarditis Systolic Anterior Motion Of The Anterior Leaflet Mitral Valve Replacement Prosthesis Orientation Prosthesis Selection Results Commissurotomy For Mitral Stenosis Early Mortality And Late Survival Functional Status Mitral Regurgitation After Commissurotomy Reintervention Valve Repair For Mitral Regurgitation Early Mortality And Late Survival Functional Status Left Ventricular Dysfunction And Remodeling Residual And Recurrent Mitral Regurgitation Thromboembolic Events Systolic Anterior Motion Of The Anterior Leaflet Infective Endocarditis Reoperation Mitral Valve Replacement Early Mortality And Late Survival Functional Status Left Ventricular Dysfunction And Remodeling Thromboembolic Events Acute Valve Thrombosis Hemorrhagic Events From Anticoagulation Structural Valve Degeneration Periprosthetic Leakage Prosthetic Valve Endocarditis Reoperation Minimally Invasive Mitral Valve Surgery Early Mortality And Late Survival Residual And Recurrent Mitral Regurgitation Postoperative Bleeding And Transfusion Pulmonary Function Length Of Stay Postoperative Pain And Cosmetic Benefits Cost Robotic Technology Risks Learning Curve Percutaneous Technology References 84 Surgical Treatment of Tricuspid Valve Disease SURGICAL ANATOMY TRICUSPID VALVE ANNULUS LEAFLETS CHORDAE TENDINEAE AND PAPILLARY MUSCLES TERMINOLOGY ANATOMIC RELATIONSHIPS PATHOPHYSIOLOGY ORGANIC TRICUSPID VALVE DISEASE FUNCTIONAL TRICUSPID REGURGITATION IATROGENIC TRICUSPID REGURGITATION INDUCED BY CARDIAC IMPLANTABLE ELECTRONIC DEVICE LEADS DIAGNOSIS INDICATIONS FOR SURGERY SPECIFIC SURGICAL INDICATIONS TREATMENT OF PRIMARY (ORGANIC) TRICUSPID DISEASE CARCINOID DISEASE TRAUMATIC TRICUSPID INSUFFICIENCY TRICUSPID INSUFFICIENCY SECONDARY TO CARDIAC IMPLANTABLE ELECTRONIC DEVICES IATROGENIC TRICUSPID REGURGITATION INFECTIVE ENDOCARDITIS TREATMENT OF FUNCTIONAL TRICUSPID REGURGITATION PROPHYLACTIC TRICUSPID REPAIR AT THE TIME OF LEFT-SIDED VALVE OPERATION FUNCTIONAL TRICUSPID REGURGITATION AFTER HEART TRANSPLANTATION FUNCTIONAL TRICUSPID REGURGITATION IN PATIENTS WITH CONGESTIVE HEART FAILURE DUE TO ISCHEMIC OR IDIOPATHIC CARDIOMYOPATHY W ... FUNCTIONAL TRICUSPID REGURGITATION IN PATIENTS UNDERGOING LVAD IMPLANTATION TRICUSPID VALVE SURGERY SURGICAL APPROACHES TO THE TRICUSPID VALVE TRICUSPID VALVE COMMISSUROTOMY TRICUSPID VALVE ANNULOPLASTY ADDITIONAL REPAIR TECHNIQUES TRICUSPID VALVE REPLACEMENT RESULTS ANNULOPLASTY TRICUSPID VALVE REPLACEMENT KNOWLEDGE AND EVIDENCE KNOWLEDGE EVIDENCE THE PRESENT CURRENT PERSPECTIVE IMAGING THE SURGICAL CONTROVERSY: PROPHYLAXIS? TRANSCATHETER TRICUSPID VALVE INTERVENTION VALVES AND TECHNIQUES TRANSCATHETER TRICUSPID VALVE INTERVENTION IN NATIVE ANATOMY ANNULOPLASTY DEVICES EDWARDS CARDIOBAND TRICUSPID ANNULOPLASTY SYSTEM MINIMALLY INVASIVE ANNULOPLASTY DA VINGI PERCUTANEOUS ANNULOPLASTY RING LEAFLET AND COAPTATION DEVICES TRICLIP PASCAL TRICUSPID REPAIR SYSTEM MISTRAL TRICUSPID VALVE REPAIR SYSTEM TRANSCATHETER TRICUSPID VALVE REPLACEMENT HETEROTOPIC VALVE REPLACEMENT ORTHOTOPIC TRICUSPID VALVE REPLACEMENT Gate Valve Evoque Lux-Valve Others REFERENCES 85 Native and Prosthetic Valve Endocarditis Native Valve Endocarditis Pathology Microbiology Diagnosis Clinical Presentation Imaging Studies Duke Criteria Treatment/Management Surgical Principles Surgery For Native Aortic Valve Endocarditis Surgery For Native Mitral Valve Endocarditis Surgery For Native Tricuspid Valve Endocarditis Results Prosthetic Valve Endocarditis Pathology Microbiology Diagnosis Treatment/Management Surgical Considerations And Results Summary References 86 Anticoagulation, Thrombosis, and Thromboembolism of Prosthetic Cardiac Valves Artificial Surfaces, Coagulation Cascades, Thrombosis, and Lysis Anticoagulation Therapy Complications of Anticoagulation Warfarin Sodium Heparin Sulfate System Direct Thrombin Inhibitors and Factor Xa Inhibitors Antiplatelet Agents Prosthetic Heart Valves Prosthetic and Mechanical Heart Valves and Thromboembolism Bioprosthetic Valves and Thromboembolism Management of Prosthetic Valve Thrombosis References 87 Robotic and Minimally Invasive Mitral Valve Surgery Evolution Of Minimally Invasive Mitral Valve Surgery Robotic Assistance Patient Selection Echocardiographic Features Computed Tomography Features Procedure Performance Anesthesia And Perfusion Port Placement Clamping And Cardioplegia Mitral Valve Repair Alternatives To Robotic Assistance Pitfalls And Challenges Learning Curve Intraoperative Injury Postoperative Bleeding Clinical Outcomes Summary References 88 Implantable Cardiac Devices for the Treatment of Bradyarrhythmias and Tachyarrhythmias Historical Perspective And Overview Basic Concepts Of Pacing And Antitachycardia Therapy Permanent Pacemakers Pulse Generator Leadless Pacemaker Pacing Sensing Basic Pacing Modes Implantable Cardioverter-Defibrillators Pulse Generator Leads Subcutaneous Implantable Cardiac-Defibrillator Tachyarrhythmia Detection Tachyarrhythmia Therapy Antitachycardia Pacing High-Energy Defibrillation Indications For Implantation Of Cardiac Devices Temporary Pacemakers Indications Venous Access And Temporary Pacing Modalities Permanent Pacemakers Indications Cardiac Resynchronization Therapy His Bundle Pacing And Left Bundle Branch Area Pacing Leadless Pacemakers Contraindications Implantable Cardioverter-Defibrillators Indications Contraindications To Implantable Cardioverter-Defibrillator Therapy Clinical Considerations Standard Transvenous Techniques For Implantation Of Cardiac Devices Temporary Transvenous Pacemakers Permanent Pacemakers Cephalic Vein (Cutdown) Approach Axillary Vein Approach Subclavian Vein Approach Technique Coronary Sinus Lead Placement for Cardiac Resynchronization Therapy His Bundle and Left Bundle Area Pacing Generator Changes Postimplantation Care of Transvenous Cardiac Devices Implantable Cardioverter-Defibrillators Complications Of Implantable Cardiac Devices Extraction Of Chronic Leads Used In Transvenous Cardiac Devices Overview Tools Used In Chronic Lead Transvenous Extractions Techniques Of Chronic Lead Transvenous Extractions Extraction Through The Implant Vein Extraction Through The Femoral Vein Complications Perioperative Management Of Cardiac Devices Pacemakers Implantable Cardioverter-Defibrillators Acknowledgments References 89 Catheter Ablation of Arrhythmias HISTORY OF CATHETER ABLATION PROCEDURAL TECHNIQUE AND THE ELECTROPHYSIOLOGY STUDY THE ELECTROPHYSIOLOGY STUDY CATHETER DESIGN EPICARDIAL ACCESS CARDIAC MAPPING TECHNIQUES CATHETER ABLATION ENERGY SOURCES RADIOFREQUENCY CRYOABLATION PULSED-FIELD ABLATION ABLATION GUIDANCE TECHNOLOGIES ELECTROANATOMIC MAPPING SYSTEMS INTRACARDIAC ECHOCARDIOGAPHY ABLATION OF TACHYARRHYTHMIAS SUPRAVENTRICULAR TACHYCARDIAS ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA ATRIAL TACHYCARDIA ACCESSORY PATHWAY–MEDIATED TACHYCARDIA ATRIAL FLUTTER ATRIAL FIBRILLATION Atrioventricular Junction Ablation Catheter Ablation of Atrial Fibrillation Cryoballoon Ablation of Atrial Fibrillation VENTRICULAR TACHYARRHYTHMIAS REENTRANT VENTRICULAR TACHYCARDIA AND STRUCTURAL HEART DISEASE PROCEDURAL APPROACH FOR VENTRICULAR TACHYCARDIA ABLATION WITH ARRHYTHMIA INDUCTION PROCEDURAL APPROACH FOR VENTRICULAR TACHYCARDIA ABLATION WITHOUT ARRHYTHMIA INDUCTION EPICARDIAL VENTRICULAR TACHYCARDIA ABLATION IDIOPATHIC VENTRICULAR TACHYCARDIA FUTURE DIRECTIONS—HYBRID SURGICAL AND CATHETER ABLATION ACKNOWLEDGMENT References 90 Surgical Treatment of Arrhythmias ATRIAL FIBRILLATION BACKGROUND CLASSIFICATION OF ATRIAL FIBRILLATION ELECTROPHYSIOLOGY OF ATRIAL FIBRILLATION MEDICAL TREATMENT HISTORICAL ASPECTS OF SURGERY FOR ATRIAL FIBRILLATION The Left Atrial Isolation Procedure Catheter Ablation of the Atrioventricular Node–His Bundle Complex The Corridor Procedure The Atrial Transection Procedure DEVELOPMENT OF THE COX-MAZE PROCEDURE SURGICAL ABLATION TECHNOLOGY RADIOFREQUENCY ENERGY CRYOABLATION SURGICAL INDICATIONS FOR TREATMENT OF ATRIAL FIBRILLATION SURGICAL TECHNIQUE: COX-MAZE PROCEDURE PULMONARY VEIN ISOLATION RIGHT ATRIAL LESION SET LEFT ATRIAL LESION SET POSTOPERATIVE CARE SURGICAL RESULTS: COX-MAZE PROCEDURE IMPROVED SURVIVAL AND REDUCED STROKE MORBIDITY SURGICAL TECHNIQUE: OTHER ATRIAL FIBRILLATION PROCEDURES SURGICAL RESULTS: OTHER ATRIAL FIBRILLATION PROCEDURES GANGLIONATED PLEXUS ABLATION HYBRID ABLATION FUTURE SURGICAL TREATMENTS FOR ATRIAL FIBRILLATION CONCLUSION INAPPROPRIATE SINUS TACHYCARDIA BACKGROUND AND INDICATIONS SURGICAL TECHNIQUE: SUPERIOR RIGHT ATRIAL ISOLATION AND SINUS NODE SPARING HYBRID ABLATION SURGICAL RESULTS CONCLUSION VENTRICULAR TACHYCARDIA BACKGROUND HISTORICAL ASPECTS OF SURGERY FOR VENTRICULAR TACHYCARDIA SURGICAL INDICATIONS FOR VENTRICULAR TACHYCARDIA SURGICAL TECHNIQUES FOR VENTRICULAR TACHYCARDIA REVASCULARIZATION Endocardial Resection LEFT VENTRICULAR RECONSTRUCTION CARDIAC ASSIST DEVICES AND HEART TRANSPLANTATION CONCLUSION REFERENCES 91 Coronary Artery Bypass Grafting Glossary History Pathomechanistic Considerations Relevant For Invasive Treatment Of CAD Imaging Of Coronary Artery Disease Assessing The Severity Of CAD Preoperative Risk Assessment Indications For Invasive Treatment Of CAD And Expected Treatment Effects Main Evidence Cabg In The Setting Of Acute Coronary Syndrome Cabg In The Setting Of Chronic Coronary Syndrome Guideline Recommendations Classic And Concomitant Indications Concomitant Noncoronary Surgery Concomitant Valve Disease Concomitant Af Ablation And Left Atrial Appendage Closure Surgical Ventricular RECONSTRUCTION (Svr) And Ventricular Aneurysms Concomitant Carotid Disease Atrial Septal Defect/Patent Foramen Ovale Rare Indications Spontaneous Coronary Artery Dissection Failed Percutaneous Coronary Intervention Previous Coronary Artery Bypass Grafting Life-Threatening Arrhythmia Value And Interpretation Of Available Evidence Preoperative Work-Up General Considerations History And Physical Examination Preoperative Diagnostic Testing Chest X-Ray Computed Tomography Echocardiography Duplex Sonography Of Arteries And Veins Magnetic Resonance Imaging Pulmonary Function Testing Laboratory Tests Electrocardiogram Ischemia And Viability Testing Medications Surgical Procedure Informed Consent Anesthesiologic Considerations Conduct Of Cabg (On Pump) Myocardial Protection Off-Pump Cabg Coronary Endarterectomy Graft Availability, Selection, And Construction Minimally Invasive Cabg And Robotics Cabg And Surgical Ventricular Reconstruction Cabg And Atrial Fibrillation Postoperative Care Postoperative Period In The Intensive Care Unit And/Or Intermediate Care Postoperative Period On The Regular Ward Role Of Rehabilitation After CABG Late Postoperative Period Future Directions References 92 Off-Pump Coronary Artery Bypass Grafting THE EVOLUTION OF OFF-PUMP CORONARY ARTERY BYPASS SURGERY TECHNICAL ASPECTS OF OFF-PUMP CORONARY ARTERY BYPASS SELF-RETAINING CORONARY STABILIZERS PREVENTING HEMODYNAMIC COMPROMISE DURING MULTIVESSEL OPCAB LEFT VENTRICULAR COMPROMISE RIGHT VENTRICULAR COMPROMISE MYOCARDIAL ISCHEMIA EXPOSURE TECHNIQUES DEEP PERICARDIAL SUTURES RIGHT PLEUROTOMY AND RIGHT VERTICAL PERICARDIOTOMY RIGHT HEMISTERNAL ELEVATION APICAL SUCTION DEVICES FUTURE DIRECTIONS NEUROLOGIC OUTCOMES VENTRICULAR DYSFUNCTION PULMONARY DYSFUNCTION RENAL DYSFUNCTION DIABETES MELLITUS OCTOGENARIANS WOMEN CONCLUSIONS REFERENCES 93 Conduit Choice for Coronary Artery Bypass Grafting INTRODUCTION HISTORY BYPASS CONDUITS LEFT INTERNAL THORACIC ARTERY PREOPERATIVE EVALUATION HARVESTING TECHNIQUE GRAFTING STRATEGY OUTCOMES AND PATENCY CONTRAINDICATIONS GREATER SAPHENOUS VEIN HARVESTING TECHNIQUE GRAFTING STRATEGY OUTCOMES AND PATENCY CONTRAINDICATIONS EVIDENCE FOR MULTIPLE ARTERIAL GRAFTING RIGHT INTERNAL THORACIC ARTERY PREOPERATIVE EVALUATION HARVESTING TECHNIQUE GRAFTING STRATEGY OUTCOMES AND PATENCY CONTRAINDICATIONS RADIAL ARTERY PREOPERATIVE SCREENING HARVESTING TECHNIQUES GRAFTING STRATEGY OUTCOMES AND PATENCY RITA VERSUS RA AS THE SECOND ARTERIAL CONDUIT CONTRAINDICATIONS GASTROEPIPLOIC ARTERY HARVESTING TECHNIQUES GRAFTING STRATEGY OUTCOMES AND PATENCY CONTRAINDICATIONS THREE OR MORE ARTERIAL GRAFTS SEQUENTIAL GRAFTING AND Y-GRAFTING SUMMARY REFERENCES 94 Less-Invasive and Robotic Approaches to Coronary Artery Bypass Grafting INTRODUCTION DIRECT EXPOSURE TECHNIQUES MINIMALLY INVASIVE CORONARY SURGERY TECHNIQUE OF MINIMALLY INVASIVE CORONARY SURGERY CORONARY ARTERY BYPASS GRAFTING Preoperative Evaluation Anatomic Physiologic Surgical Operating Room (OR) Preparation Anesthetic Preparation Patient Positioning (Fig. 94.1) Instruments Needed Access Incision (Fig. 94.2) Internal Thoracic Artery Harvest Proximal Anastomoses (Fig. 94.3) Distal Anastomosis Coronary Artery Exposure. Chest Closure ROBOTIC-ASSISTED TECHNIQUE ROBOTIC-ASSISTED CORONARY ARTERY BYPASS GRAFTING HISTORICAL PERSPECTIVE AND CURRENT STATUS OVERVIEW IN TECHNIQUES GENERAL CONSIDERATIONS FOR ROBOTIC-ASSISTED CORONARY ARTERY BYPASS GRAFTING Preoperative Selection OR Preparation Anesthetic Considerations. Patient Positioning. OR Setup. TECHNIQUES OF ROBOTIC-ASSISTED CORONARY ARTERY BYPASS GRAFTING Port Placement Internal Thoracic Artery Harvest RITA Harvest Left Internal Thoracic Artery Harvest Anastomoses Via Thoracotomy Anastomoses Via Total Endoscopic Coronary Artery Bypass Cardiopulmonary Bypass Assistance With or Without Cardioplegic Arrest During Total Endoscopic Coronary Artery Bypass. Distal Anastomosis With Anastomotic Devices Handsewn Distal Anastomosis Completion of Procedure COMPLICATIONS IN CONVENTIONAL AND ROBOTICALLY ASSISTED LESS-INVASIVE CABG Robotic Instrument–Related Complications Conversion to Pump-Assist or Sternotomy Retrograde Aortic Dissection Failure of Deployment of Anastomotic Devices HYBRID CORONARY REVASCULARIZATION CONCLUSION REFERENCES 95 Redo Coronary Artery Bypass Surgery INTRODUCTION INDICATIONS FOR CORONARY REOPERATIONS AND PREOPERATIVE EVALUATION CONDUCT OF A CORONARY REOPERATION REOPENING A MEDIASTINAL INCISION CARDIOPULMONARY BYPASS AND CARDIOPLEGIC ARREST BYPASS GRAFTING PATTERNS SPECIAL SITUATIONS: VALVE-GRAFT REOPERATIONS, MINIMALLY INVASIVE REOPERATIONS, OFF-PUMP REOPERATIONS, AND LASER REVASCULARI ... SHORT- AND LONG-TERM RESULTS OF REOPERATION REFERENCES 96 Ischemic Mitral Regurgitation DEFINITIONS PATHOPHYSIOLOGY SPECIFIC GEOMETRIC ABNORMALITIES ANNULAR SUBVALVULAR APPARATUS LEFT VENTRICLE LEAFLET DYSFUNCTION PATHOPHYSIOLOGIC SEQUELAE OF SEVERE ISCHEMIC MITRAL REGURGITATION PROPORTIONATE VERSUS DISPROPORTIONATE MITRAL REGURGITATION CLINICAL PRESENTATION EVALUATING ISCHEMIC MITRAL REGURGITATION ECHOCARDIOGRAPHY MAGNETIC RESONANCE IMAGING CARDIAC COMPUTED TOMOGRAPHY THERAPEUTIC TARGETS IN ISCHEMIC MITRAL REGURGITATION CORONARY ARTERY DISEASE LEFT VENTRICLE MITRAL ANNULUS SUBVALVULAR APPARATUS LEAFLETS PATIENT MANAGEMENT TREATMENT MODALITIES MEDICAL THERAPY PERCUTANEOUS THERAPY SURGERY DECISION MAKING SEVERE ISCHEMIC MITRAL REGURGITATION WITH CONGESTIVE HEART FAILURE MILD OR MODERATE ISCHEMIC MITRAL REGURGITATION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING PROGNOSTIC IMPACT OF ISCHEMIC MITRAL REGURGITATION EFFECT OF ISCHEMIC MITRAL REGURGITATION ON SURVIVAL AFTER MYOCARDIAL INFARCTION EFFECT OF ISCHEMIC MITRAL REGURGITATION ON SURVIVAL AFTER PERCUTANEOUS CORONARY INTERVENTION EFFECT OF ISCHEMIC MITRAL REGURGITATION ON SURVIVAL AFTER CORONARY ARTERY BYPASS GRAFTING IMPACT OF MITRAL VALVE SURGERY ON SURVIVAL AFTER CORONARY ARTERY BYPASS GRAFTING SURGICAL PRINCIPLES BASIC PRINCIPLES ANNULOPLASTY: OPTIONS AND PRINCIPLES VALVE EXPOSURE VALVE ANALYSIS SUTURE PLACEMENT SIZING AND IMPLANTATION ADJUNCTIVE PROCEDURES PAPILLARY MUSCLE REPOSITIONING PROCEDURES SECONDARY CHORDAE CUTTING OTHER APPROACHES IS RESTRICTIVE ANNULOPLASTY HARMFUL? RESIDUAL MITRAL REGURGITATION AFTER ISCHEMIC MITRAL VALVE REPAIR SURGICAL TECHNIQUES AND INCIDENCE OF RESIDUAL MITRAL REGURGITATION POSSIBLE MECHANISMS OF RESIDUAL MITRAL REGURGITATION PATIENT FACTORS ASSOCIATED WITH RESIDUAL REGURGITATION INCREMENTAL OPERATIVE RISK OF MITRAL VALVE SURGERY (VERSUS CORONARY ARTERY BYPASS GRAFTING ALONE) IN ISCHEMIC MITRAL REGURG ... MITRAL VALVE REPAIR VERSUS REPLACEMENT FOR ISCHEMIC MITRAL REGURGITATION OVERALL RECOMMENDATIONS FOR SURGICAL MANAGEMENT OF ISCHEMIC MITRAL REGURGITATION IN PATIENTS UNDERGOING CORONARY ARTERY BYP ... TYPE II ISCHEMIC MITRAL REGURGITATION ACUTE TYPE II ISCHEMIC MITRAL REGURGITATION CHRONIC TYPE II ISCHEMIC MITRAL REGURGITATION REFERENCES 97 Postinfarction Ventricular Septal Defect and Ventricular Rupture HISTORICAL PERSPECTIVE ETIOLOGY AND PATHOGENESIS PATHOPHYSIOLOGY CLINICAL PRESENTATION, PREOPERATIVE MANAGEMENT, AND RISK STRATIFICATION PRESENTATION DIAGNOSIS PREDICTORS OF RISK PREOPERATIVE CONSIDERATIONS EARLY VERSUS DELAYED SURGERY SURGICAL REPAIR VERSUS TRANSCATHETER CLOSURE OPERATIVE MANGAGEMENT General Principles INFARCTECTOMY APICAL AMPUTATION FREE-WALL RUPTURE Anterior Septal Rupture Posteroinferior Septal Rupture INFARCT EXCLUSION WITH ENDOCARDIAL PATCH REPAIR INTRAOPERATIVE MANAGEMENT WEANING FROM CARDIOPULMONARY BYPASS BLEEDING ROLE OF VENTRICULAR ASSIST DEVICES POSTOPERATIVE MANAGEMENT OUTCOMES OPERATIVE MORTALITY LONG-TERM RESULTS RECURRENT SEPTAL DEFECTS SUMMARY REFERENCES 98 Nonatherosclerotic Coronary Artery Disease CORONARY ARTERY ANOMALIES ANOMALOUS AORTIC ORIGIN OF CORONARY ARTERIES ANOMALOUS PULMONARY ORIGIN OF CORONARY ARTERIES ANOMALOUS LEFT MAIN CORONARY ARTERY FROM THE PULMONARY ARTERY OTHER ANOMALOUS PULMONARY ORIGINS OF CORONARY ARTERIES SINGLE CORONARY ARTERY LEFT MAIN CORONARY ARTERY ATRESIA HIGH TAKEOFF CORONARY OSTIA CORONARY ARTERY FISTULA MUSCLE BRIDGE CORONARY ANEURYSMS (CORONARY ARTERY ECTASIA AND DILATING CORONARY ATHEROSCLEROSIS) MECHANICAL INJURY TO THE CORONARY ARTERY CORONARY ARTERY EMBOLIZATION CORONARY ARTERY DISSECTION SPONTANEOUS CORONARY ARTERY DISSECTION CORONARY ARTERY TRAUMA BLUNT TRAUMA PENETRATING TRAUMA IATROGENIC CORONARY ARTERY TRAUMA PROGRESSIVE NONATHEROSCLEROTIC CORONARY OCCLUSIVE DISEASE CORONARY ARTERY VASCULITIS POLYARTERITIS NODOSA SYSTEMIC LUPUS ERYTHEMATOSUS WEGENER GRANULOMATOSIS TAKAYASU DISEASE MUCOCUTANEOUS LYMPH NODE SYNDROME (KAWASAKI DISEASE) COVID-19-ASSOCIATED ACUTE CORONARY SYNDROMES INTIMAL PROLIFERATION AND FIBROSIS IONIZING RADIATION CARDIAC TRANSPLANTATION EXTRINSIC CORONARY ARTERY COMPRESSION SUBSTANCE ABUSE REFERENCES 99 Pericardium and Constrictive Pericarditis THE PERICARDIUM HISTORY ANATOMY NORMAL PHYSIOLOGY PATHOPHYSIOLOGY PERICARDIAL EFFUSION CARDIAC TAMPONADE PULSUS PARADOXUS CONSTRICTIVE PERICARDITIS DIAGNOSIS OF PERICARDIAL DISEASE HISTORY AND SYMPTOMS PHYSICAL EXAMINATION CHEST RADIOGRAPH ELECTROCARDIOGRAM ECHOCARDIOGRAPHY COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING CARDIAC CATHETERIZATION PERICARDIOCENTESIS Pericardial Biopsy NONCONSTRICTIVE PERICARDITIS DIAGNOSIS ETIOLOGY AND TREATMENT IDIOPATHIC PERICARDITIS INFECTIOUS PERICARDITIS AUTOIMMUNE PERICARDITIS TYPE 2 IMMUNE AND POSTOPERATIVE PERICARDITIS MALIGNANT PERICARDITIS TRAUMATIC AND RADIATION-INDUCED PERICARDITIS METABOLIC AND UREMIC PERICARDITIS PERICARDITIS FROM SURROUNDING STRUCTURES CHYLOPERICARDIUM HEMOPERICARDIUM PNEUMOPERICARDIUM CARDIAC TAMPONADE ETIOLOGY DIAGNOSIS TREATMENT CONSTRICTIVE PERICARDITIS ETIOLOGY DIAGNOSIS TREATMENT PERICARDIAL CYSTS AND DIVERTICULA PERICARDIAL TUMORS PERICARDIAL DEFECTS PERICARDIAL SURGICAL PROCEDURES SUBXIPHOID PERICARDIAL WINDOW PERICARDIOSCOPY TRANSPLEURAL PERICARDIAL WINDOW/PERICARDIECTOMY TRANSDIAPHRAGMATIC PERICARDIAL WINDOW PERICARDIECTOMY REFERENCES 100 Surgical Management of Hypertrophic Cardiomyopathy DEFINITION MORPHOLOGY DISTRIBUTION OF HYPERTROPHY MITRAL VALVE RIGHT VENTRICLE AORTIC VALVE CORONARY ARTERIES HISTOPATHOLOGY MYOCARDIAL FIBER DISARRAY INTERSTITIAL FIBROSIS DIFFERENTIAL DIAGNOSIS GENETICS PATHOPHYSIOLOGY DIASTOLIC DYSFUNCTION LEFT VENTRICULAR OUTFLOW OBSTRUCTION MITRAL VALVE REGURGITATION CALCIFICATION OF MITRAL APPARATUS CLINICAL PRESENTATION AND DIAGNOSTIC CRITERIA SYMPTOMS SIGNS ELECTROCARDIOGRAPHY AND CHEST RADIOGRAPHY ECHOCARDIOGRAPHY CARDIAC MAGNETIC RESONANCE IMAGING INVASIVE CATHETERIZATION NATURAL HISTORY SYMPTOM COURSE SURVIVAL OBSTRUCTIVE VERSUS NONOBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY USE OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SURGICAL TREATMENT INDICATIONS FOR OPERATION TECHNIQUE OF OPERATION MANAGEMENT OF CONCOMITANT CARDIOVASCULAR DISORDERS MITRAL VALVE ATRIAL FIBRILLATION ATHEROSCLEROSIS CORONARY ARTERY DISEASE MYOCARDIAL BRIDGING OF CORONARY ARTERY POSTOPERATIVE CARE OUTCOMES EARLY RESULTS MORTALITY MORBIDITY LATE RESULTS SYMPTOM RELIEF SURVIVAL COMPARISON TO SEPTAL ARTERY ABLATION TIMING OF INTERVENTION SPECIAL SUBGROUPS REFERENCES 101 Ventricular Assist Device and Total Artificial Heart INTRODUCTION HISTORICAL PERSPECTIVE IMPLANT STRATEGIES FOR MECHANICAL CIRCULATORY SUPPORT BRIDGE TO TRANSPLANT DESTINATION THERAPY BRIDGE TO CANDIDACY BRIDGE TO DECISION BRIDGE TO RECOVERY INDICATIONS FOR MECHANICAL CIRCULATORY SUPPORT PATIENTS IN ACUTE CARDIOGENIC SHOCK CARDIOGENIC SHOCK AFTER ACUTE MYOCARDIAL INFARCTION CARDIOGENIC SHOCK AFTER CARDIOTOMY MYOCARDITIS REFRACTORY VENTRICULAR ARRHYTHMIAS PATIENTS WITH CHRONIC ADVANCED HEART FAILURE PATIENT SELECTION DEVICE SELECTION TYPES OF DEVICES SHORT-TERM MECHANICAL CIRCULATORY SUPPORT PERCUTANEOUS DEVICES FOR SHORT-TERM MECHANICAL SUPPORT Intra-Aortic Balloon Pump Extracorporeal Membrane Oxygenation TandemHeart Abiomed Impella SURGICAL DEVICES FOR SHORT-TERM MECHANICAL SUPPORT CentriMag LONG-TERM MECHANICAL CIRCULATORY SUPPORT PULSATILE DEVICES—FIRST-GENERATION DEVICES Thoratec HeartMate XVE AXIAL-FLOW PUMPS—SECOND-GENERATION DEVICES Thoratec HeartMate II THIRD-GENERATION PUMPS HeartWare HeartWare Ventricular Assist Device HeartMate 3 (Abbott) TOTAL ARTIFICIAL HEART SYNCCARDIA Carmat TAH SURGICAL TECHNIQUE USED FOR DURABLE LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION CONCOMITANT VALVE SURGERY OTHER CONCOMITANT PROCEDURE POSTOPERATIVE MANAGEMENT AFTER DURABLE LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION EARLY POSTOPERATIVE MANAGEMENT LATE POSTOPERATIVE MANAGEMENT ANTICOAGULATION COMPLICATIONS POSTOPERATIVE BLEEDING GASTROINTESTINAL BLEEDING AND EPISTAXIS INFECTION MULTISYSTEM ORGAN FAILURE THROMBOEMBOLISM RIGHT VENTRICULAR FAILURE ARRHYTHMIA AORTIC INSUFFICIENCY DEVICE MALFUNCTION SUMMARY REFERENCES 102 Heart Transplantation INTRODUCTION HISTORICAL BACKGROUND RECIPIENT CONSIDERATIONS EVALUATIONS FOR HEART TRANSPLANTATION INDICATIONS FOR HEART TRANSPLANTATION UNITED NETWORK FOR ORGAN SHARING STATUS AND CRITERIA DONOR CONSIDERATIONS DONOR SELECTION DONOR MANAGEMENT OPERATIONS DONOR HEART PROCUREMENT PROCEDURE ADVANCED ORGAN PRESERVATION DONATION AFTER CARDIAC DEATH HEART TRANSPLANT PROCEDURE POSTOPERATIVE MANAGEMENT IMMUNOSUPPRESSION OUTCOMES FUTURE PERSPECTIVES REFERENCES 103 Heart-Lung Transplantation INDICATIONS FOR HEART-LUNG TRANSPLANTATION RECIPIENT DIAGNOSIS RECIPIENT SELECTION CRITERIA TREATMENT OF PATIENTS AWAITING TRANSPLANTATION SELECTION AND MANAGEMENT OF DONORS HEART-LUNG PRESERVATION OPERATIVE TECHNIQUE FOR DONOR HEART-LUNG REMOVAL OPERATIVE PROCEDURE POSTOPERATIVE MANAGEMENT INTENSIVE CARE UNIT IMMUNOSUPPRESSION COMPLICATIONS ACUTE REJECTION INFECTION CHRONIC REJECTION—OBLITERATIVE BRONCHIOLITIS CHRONIC REJECTION—GRAFT CORONARY ARTERY DISEASE COMPLICATIONS OF IMMUNOSUPPRESSION ADDITIONAL COMPLICATIONS PHYSIOLOGY OF THE TRANSPLANTED LUNG LATE RESULTS FUTURE DEVELOPMENTS REFERENCES 104 Left Ventricular Restoration: Surgical Treatment of the Failing Heart PATHOPHYSIOLOGY OF HEART FAILURE LEFT VENTRICULAR REMODELING LEFT VENTRICULAR GEOMETRIC ABNORMALITIES IN ISCHEMIC AND NONISCHEMIC VENTRICLES RATIONALE FOR RESHAPING CARDIAC ARCHITECTURE LEFT VENTRICULAR ANEURYSM OR ISCHEMIC DILATED CARDIOMYOPATHY? LEFT VENTRICULAR ANEURYSMECTOMY DIAGNOSIS AND PATIENT SELECTION FOR SURGERY NONISCHEMIC CARDIOMYOPATHY ISCHEMIC CARDIOMYOPATHY STATUS OF REMOTE REGIONS SURGICAL VENTRICULAR RESTORATION FOR ISCHEMIC CARDIOMYOPATHY SURGICAL DETAILS OF ANTERIOR SURGICAL VENTRICULAR RESTORATION MITRAL VALVE REPAIR DURING SURGICAL VENTRICULAR RESTORATION SURGICAL DETAILS OF POSTERIOR SURGICAL VENTRICULAR RESTORATION OUTCOMES SURGICAL VENTRICULAR RESTORATION AND DIASTOLIC FUNCTION SURGICAL VENTRICULAR RESTORATION AND LEFT VENTRICULAR DYSSYNCHRONY SURGICAL VENTRICULAR RESTORATION AND VENTRICULAR ARRHYTHMIAS SURGICAL VENTRICULAR RESTORATION AND MITRAL VALVE SURGERY CORONARY ARTERY BYPASS SURGERY CORONARY ARTERY BYPASS SURGERY WITH OR WITHOUT SURGICAL VENTRICULAR RESTORATION: INSIGHTS INTO THE STICH TRIAL NEW INSIGHTS CHANGES IN NATRIURETIC PEPTIDES AND THE CHALLENGE OF SURGICAL REVERSE REMODELING SURGICAL VENTRICULAR RESTORATION IN MEN AND WOMEN: THE LARGEST SINGLE-CENTER COMPARISON SUMMARY References 105 Regenerative Cell-Based Therapy for the Treatment of Cardiac Disease INTRODUCTION DELIVERY METHODS FOR CELL TRANSPLANTATION INTRAVENOUS INFUSION INTRACORONARY INFUSION INTRAMYOCARDIAL INJECTION SUMMARY ADULT STEM OR PROGENITOR CELLS FOR CARDIAC CELL THERAPY BONE MARROW–DERIVED CELLS UNFRACTIONATED BONE MARROW CELLS HEMATOPOIETIC STEM CELLS ENDOTHELIAL PROGENITOR CELLS FRACTIONATED CD34+ BONE MARROW CELLS Mesenchymal Stem Cells SUMMARY OF BONE MARROW CELL–DERIVED PRODUCTS PLURIPOTENT CELLS CARDIAC-DERIVED CELLS CARDIOSPHERE-DERIVED CELLS COMBINATION PRODUCTS POTENTIAL MECHANISMS OF ACTION FOR CELL-BASED REGENERATIVE THERAPIES TRANSDIFFERENTIATION AND CELL FUSION OF TRANSPLANTED CELLS NEOVASCULARIZATION FROM TRANSPLANTED CELLS THE PARACRINE HYPOTHESIS Neovascularization Cardioprotection Modulation of Inflammation Extracellular Matrix REMODELING Inhibition of Hypertrophy CURRENT CHALLENGES AND FUTURE DIRECTIONS FOR CARDIAC REGENERATIVE MEDICINE PATIENT CLINICAL CHARACTERISTICS MEASURES OF EFFICACY TRANSPLANTED CELL DYSFUNCTION AND EX VIVO CELL PRIMING AUTOLOGOUS VERSUS ALLOGENEIC CELLS CELL ENGRAFTMENT AND BIOMATERIALS IN SITU CELL THERAPY SUMMARY References 106 Surgery for Pulmonary Embolism and Chronic Thromboembolic Pulmonary Hypertension INTRODUCTION ACUTE PULMONARY THROMBOEMBOLIC DISEASE CLINICAL POINTS PROPHYLAXIS FOR PULMONARY EMBOLISM SUPPORTIVE AND THROMBOLYTIC THERAPY FOR PULMONARY EMBOLISM PERCUTANEOUS TREATMENTS ACUTE PULMONARY EMBOLECTOMY EXTRACORPOREAL LIFE SUPPORT RESULTS OF ACUTE PULMONARY EMBOLECTOMY CHRONIC PULMONARY THROMBOEMBOLIC DISEASE INCIDENCE AND NATURAL HISTORY CLINICAL MANIFESTATIONS DIAGNOSTIC EVALUATION OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION SURGICAL SELECTION GUIDING PRINCIPLES OF THE OPERATION PULMONARY ENDARTERECTOMY—SURGICAL TECHNIQUE THROMBOEMBOLIC DISEASE CLASSIFICATION AND PREDICTION OF SURGICAL OUTCOME RESULTS OF PULMONARY ENDARTERECTOMY SURGERY ALTERNATIVE THERAPIES FOR CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION SUMMARY REFERENCES 107 Neoplasms of the Heart and Great Vessels INTRODUCTION GENERAL CLASSIFICATION OF NEOPLASMS PATHOLOGY AND MOLECULAR BIOLOGY OF CARDIAC NEOPLASMS CLINICAL PRESENTATION OF CARDIAC NEOPLASMS IMAGING FOR CARDIAC NEOPLASMS BENIGN PRIMARY CARDIAC NEOPLASMS PAPILLARY FIBROELASTOMAS MYXOMAS OTHER BENIGN NEOPLASMS MALIGNANT PRIMARY CARDIAC NEOPLASMS SARCOMAS LYMPHOMAS MESOTHELIOMA METASTATIC CARDIAC NEOPLASMS PEDIATRIC NEOPLASMS NEOPLASMS OF THE GREAT VESSELS SURGICAL RESECTION OF MALIGNANT NEOPLASMS AND AUTOTRANSPLANTATION HEART TRANSPLANTATION MECHANICAL CARDIAC REPLACEMENT References 108 Cardiac Embryology and Genetics CARDIAC SPECIFICATION BODY-PLAN LATERALITY AND CARDIAC LOOPING CLINICAL CORRELATE OF ABNORMAL LATERALITY: HETEROTAXY SYNDROME CHAMBER SPECIFICATION AND THE CARDIOGENIC TRANSCRIPTIONAL PROGRAM CARDIAC SEPTATION OF THE ATRIA, VENTRICLES, ATRIOVENTRICULAR JUNCTION, AND OUTFLOW TRACT CLINICAL CORRELATES OF ABNORMAL CHAMBER SEPTATION OUTFLOW TRACT DEVELOPMENT: ANTERIOR HEART FIELD AND CARDIAC NEURAL CREST CLINICAL CORRELATES OF ABNORMAL OUTFLOW TRACT DEVELOPMENT: DIGEORGE SYNDROME AND 22q11 DELETION THE CAUSES OF CONGENITAL HEART DISEASE: ADDITIONAL FACTORS GENETIC ABNORMALITIES ASSOCIATED WITH CONGENITAL HEART DISEASE CONCLUSION ACKNOWLEDGMENT REFERENCES 109 Segmental Anatomy VISCERAL SITUS LOCATION OF THE HEART SEGMENTAL ANALYSIS SEGMENTAL SITUS SEGMENTAL ALIGNMENTS SEGMENTAL CONNECTIONS DISHARMONY BETWEEN SITUS AND ALIGNMENT EXAMPLES OF SEGMENTAL ANALYSIS SUMMARY ACKNOWLEDGMENT REFERENCES 110 Diagnostic Imaging: Echocardiography, Magnetic Resonance Imaging, and Computed Tomography INTRODUCTION ECHOCARDIOGRAPHY AND DOPPLER ULTRASOUND DESCRIPTION OF TECHNIQUE M-MODE ECHOCARDIOGRAPHY TWO-DIMENSIONAL ECHOCARDIOGRAPHY THREE-DIMENSIONAL ECHOCARDIOGRAPHY DOPPLER ECHOCARDIOGRAPHY SPECKLE-TRACKING ECHOCARDIOGRAPHY CONTRAST ECHOCARDIOGRAPHY OBJECTIVES OF THE ECHOCARDIOGRAPHIC EXAMINATION EXAMINATION TECHNIQUE ANATOMIC ANALYSIS SPECIAL ECHOCARDIOGRAPHIC PROCEDURES TRANSESOPHAGEAL ECHOCARDIOGRAPHY INDICATIONS AND OBJECTIVES SAFETY AND COMPLICATIONS EPICARDIAL ECHOCARDIOGRAPHY INDICATIONS AND OBJECTIVES EXAMINATION TECHNIQUE FETAL ECHOCARDIOGRAPHY INDICATIONS AND OBJECTIVES EXAMINATION TECHNIQUE CLINICAL IMPLICATIONS QUANTITATIVE ANALYSIS ADJUSTMENT OF MEASUREMENTS TO BODY SIZE VENTRICULAR FUNCTION DOPPLER EVALUATION OF PRESSURE GRADIENTS CALCULATION OF PRESSURE GRADIENTS SAFETY AND COMPLICATIONS MAGNETIC RESONANCE IMAGING MAGNETIC RESONANCE IMAGING TECHNIQUES AND THEIR CLINICAL APPLICATIONS CARDIAC AND RESPIRATORY GATING ANATOMIC IMAGING AND TISSUE CHARACTERISTICS CINE MAGNETIC RESONANCE IMAGING MAGNETIC RESONANCE IMAGING ASSESSMENT OF VENTRICULAR FUNCTION BLOOD FLOW ANALYSIS CONTRAST-ENHANCED MAGNETIC RESONANCE ANGIOGRAPHY MYOCARDIAL ISCHEMIA AND VIABILITY INDICATIONS FOR CARDIOVASCULAR MAGNETIC RESONANCE IMAGING GENERAL CONSIDERATIONS SAFETY AND COMPLICATIONS COMPUTED TOMOGRAPHY COMPUTED TOMOGRAPHY IMAGING TECHNIQUES AND THEIR CLINICAL APPLICATIONS SAFETY AND COMPLICATIONS SUMMARY REFERENCES 111 3D Image Reconstruction and Surgical Planning INTRODUCTION AND OVERVIEW WORKFLOW AND APPLICATIONS OF 3D MODELS DIGITAL DISPLAY OF 3D MODELS 3D PRINTING VIRTUAL SURGERY QUANTITATIVE RECONSTRUCTIVE PLANNING FLOW MODELING INTRAOPERATIVE GUIDANCE LESION-SPECIFIC APPLICATION OF 3D MODELS DOUBLE-OUTLET RIGHT VENTRICLE BIVENTRICULAR REPAIR MULTIPLE MUSCULAR VSDs MAJOR AORTOPULMONARY COLLATERAL ARTERIES CARDIAC TUMORS SINGLE VENTRICLE AORTIC ARCH RECONSTRUCTION AIRWAYS HEART VALVES VENTRICULAR ASSIST DEVICE FIT TESTING OTHER LESIONS FUTURE PERSPECTIVE REFERENCES 112 Cardiac Catheterization and Fetal Intervention ROLES OF DIAGNOSTIC CATHETERIZATION INVASIVE IMAGING HEMODYNAMIC ASSESSMENT RESISTANCES VASCULAR ACCESS STANDARD ARTERIAL AND VENOUS ACCESS ALTERNATE ROUTES OF ACCESS UMBILICAL VESSELS BRACHIOCEPHALIC VESSELS TRANSHEPATIC VENOUS ACCESS SURGICAL CUTDOWN AND PERVENTRICULAR ACCESS INTERVENTIONS BALLOON ATRIAL SEPTOSTOMY VALVE INTERVENTIONS PULMONARY VALVULOPLASTY AORTIC VALVULOPLASTY BALLOON MITRAL VALVULOPLASTY TRANSCATHETER PULMONARY VALVE REPLACEMENT VASCULAR INTERVENTIONS STENTING OF THE PATENT DUCTUS ARTERIOSUS IN NEWBORNS WITH DUCTAL-DEPENDENT CONGENITAL HEART DISEASE TRANSCATHETER THERAPIES FOR VASCULAR STENOSES COARCTATION OF THE AORTA BALLOON AND STENT ANGIOPLASTY OF BRANCH PULMONARY ARTERIES CONDUITS, SYSTEMIC AND PULMONARY VEINS RIGHT VENTRICLE TO PULMONARY ARTERY CONDUITS SYSTEMIC VENOUS OBSTRUCTION PULMONARY VEIN STENOSIS OCCLUSION OF SHUNTS PATENT DUCTUS ARTERIOSUS ATRIAL SEPTAL DEFECT CLOSURE VENTRICULAR SEPTAL DEFECT CLOSURE COLLATERAL VESSELS AND SURGICALLY CREATED AORTOPULMONARY SHUNTS SURGICAL-INTERVENTIONAL COLLABORATION THE ROLE OF DIAGNOSTIC AND INTERVENTIONAL CATHETERIZATION IN THE POSTOPERATIVE MANAGEMENT OF CONGENITAL HEART DISEASE HYBRID PROCEDURES HYBRID MANAGEMENT STRATEGIES IN CONGENITAL HEART DISEASE FETAL CARDIAC INTERVENTIONS FETAL AORTIC VALVULOPLASTY FOR SEVERE MID-GESTATION AORTIC STENOSIS WITH EVOLVING HYPOPLASTIC LEFT HEART SYNDROME FETAL STENTING OF THE INTERATRIAL SEPTUM IN HYPOPLASTIC LEFT HEART SYNDROME WITH INTACT OR HIGHLY RESTRICTIVE ATRIAL SEPTUM FETAL PULMONARY VALVE PERFORATION AND BALLOON DILATION FOR PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM References 113 Surgical Approaches and Cardiopulmonary Bypass for Pediatric Cardiac Surgery APPROACHES TO CARDIAC STRUCTURES AND GREAT VESSELS FOR TRANSTHORACIC CANNULATION FOR CARDIOPULMONARY BYPASS FULL STERNOTOMY LIMITED STERNOTOMY INCISIONS TRANSXYPHOID MINISTERNOTOMY MIDSTERNAL MINISTERNOTOMY ANTERIOR OR ANTEROLATERAL THORACOTOMY APPROACHES TO EXTRACARDIAC STRUCTURES IN INFANTS AND CHILDREN THORACOSCOPIC APPROACH IN CHILDREN CARDIOPULMONARY BYPASS IN CHILDREN HISTORY DIFFERENCES BETWEEN PEDIATRIC AND ADULT CARDIOPULMONARY BYPASS MONITORING DURING PEDIATRIC CARDIOPULMONARY BYPASS CIRCUIT MONITORING PATIENT MONITORING Heparinization Heparin Reversal THE CARDIOPULMONARY BYPASS PLAN TEAM PREPAREDNESS AND COMMUNICATION HEART-LUNG MACHINES OXYGENATOR, TUBING, AND CIRCUIT SPECIFICATIONS ARTERIAL, VENOUS, AND OTHER CANNULAE THE BYPASS PRIME, HEMATOCRIT, AND MEDICATIONS PUMP FLOW TEMPERATURE MANAGEMENT BLOOD GAS MANAGEMENT ULTRAFILTRATION TECHNIQUES AUTOLOGOUS CELL SALVAGE MYOCARDIAL PROTECTION MAINTENANCE OF CIRCUIT VIABILITY THE PERFUSION TEAM LOW-FLOW HYPOTHERMIC CARDIOPULMONARY BYPASS DEEP HYPOTHERMIC CIRCULATORY ARREST BLEEDING AFTER PEDIATRIC CARDIOPULMONARY BYPASS TREATMENT OF BLEEDING AFTER CARDIOPULMONARY BYPASS ORGAN INJURY DURING PEDIATRIC CARDIOPULMONARY BYPASS PULMONARY EFFECTS RENAL EFFECTS BRAIN INJURY STRESS RESPONSE TO CARDIOPULMONARY BYPASS SYSTEMIC INFLAMMATORY RESPONSE TO CARDIOPULMONARY BYPASS References 114 Mechanical Circulatory Support in Children EXTRACORPOREAL MEMBRANE OXYGENATION OVERVIEW OF USES EXTRACORPOREAL MEMBRANE OXYGENATION INDICATIONS PREOPERATIVE STABILIZATION INABILITY TO WEAN FROM CARDIOPULMONARY BYPASS POST-CARDIOTOMY ECMO SUPPORT CARDIOMYOPATHY, MYOCARDITIS, AND BRIDGE TO TRANSPLANTATION AFTER IN-HOSPITAL CARDIAC ARREST AND CARDIOPULMONARY RESUSCITATION TECHNICAL ASPECTS OF EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION ACCESS SPECIAL CIRCUMSTANCES SINGLE VENTRICLE FEMORAL CANNULATION NECK CANNULATION LEFT HEART VENTING CONDUCT OF CANNULATION CIRCUIT AND CANNULA MANAGEMENT WEANING FROM EXTRACORPOREAL MEMBRANE OXYGENATION VENTRICULAR ASSIST DEVICES INTRODUCTION DEVICE OPTIONS PATIENT SELECTION DEVICE AND PATIENT OUTCOMES EXPANDING VAD SUPPORT TO CHALLENGING PEDIATRIC POPULATIONS SINGLE-VENTRICLE ANATOMY AND VENTRICULAR ASSIST DEVICE SUPPORT POSTTRANSPLANT GRAFT FAILURE AND VENTRICULAR ASSIST DEVICE SUPPORT DESTINATION VENTRICULAR ASSIST DEVICE THERAPY IN CHILDREN REFERENCES 115 Pediatric Anesthesia and Critical Care PATHOPHYSIOLOGY PHYSIOLOGIC APPROACH TO CONGENITAL HEART DISEASE SINGLE-VENTRICLE PHYSIOLOGY INTERCIRCULATORY MIXING SIMPLE SHUNTS COMPLEX SHUNTS OUTFLOW OBSTRUCTION PULMONARY HYPERTENSION PREOPERATIVE EVALUATION MONITORING NEUROLOGIC MONITORING INTRAOPERATIVE ECHOCARDIOGRAPHY ANESTHESIA RISKS OF ANESTHESIA FOR CHILDREN WITH CONGENITAL HEART DISEASE INDUCTION OF ANESTHESIA MAINTENANCE OF ANESTHESIA STRESS RESPONSE DISCONTINUATION OF CARDIOPULMONARY BYPASS POSTOPERATIVE MANAGEMENT ANALGESIA SEDATIVES Delirium ASSESSMENT OF CARDIAC OUTPUT FLUID MANAGEMENT PULMONARY FUNCTION AND MECHANICAL VENTILATION WEANING FROM MECHANICAL VENTILATION ENHANCED RECOVERY AFTER SURGERY AND EARLY TRACHEAL EXTUBATION DISCHARGE REFERENCES 116 Enhanced Recovery After Congenital Cardiac Surgery INTRODUCTION GUIDELINE DEVELOPMENT TEAM COMPOSITION MULTIDISCIPLINARY EFFORT PROGRAM COORDINATION MAJOR PROGRAM COMPONENTS PREOPERATIVE PHASE EDUCATION PREOPERATIVE FASTING AND CARBOHYDRATES INTRAOPERATIVE PHASE ANESTHESIA AND PERFUSION BLOOD TRANSFUSION MINIMALLY INVASIVE SURGERY RESIDUAL LESION SCORE POSTOPERATIVE PHASE EMERGENCE AND EXTUBATION TARGET DELIRIUM PROPHYLAXIS AGAINST NAUSEA AND VOMITING MULTIMODAL PAIN MANAGEMENT EARLY MOBILIZATION REMOVAL OF TUBES AND LINES POST-DISCHARGE PHASE INCLUSION and EXCLUSION IMPLEMENTATION PROCESS IMPROVEMENT OPPORTUNITIES PROGRAM REVIEW AND VALUE LOCAL RESULTS AND MULTI-INSTITUTIONAL COLLABORATIONS ACKNOWLEDGMENTS References 117 Congenital Tracheal Disease HISTORY OF PEDIATRIC TRACHEAL SURGERY CONGENITAL TRACHEAL STENOSIS TRACHEOBRONCHOMALACIA AND TRACHEOBRONCHIAL COMPRESSION SURGICAL ANATOMY CLINICAL PRESENTATION AND DIAGNOSIS CLINICAL PRESENTATION DIAGNOSTIC TECHNIQUES SURGICAL TECHNIQUES GENERAL PRINCIPLES SURGICAL MANAGEMENT OF TRACHEAL STENOSIS SLIDE TRACHEOPLASTY TRACHEAL RESECTION TRACHEOPLASTY WITH BIOMATERIAL SURGICAL MANAGEMENT OF TRACHEOBRONCHOMALACIA AND EXCESSIVE DYNAMIC AIRWAY COLLAPSE POSTERIOR TRACHEOBRONCHOPEXY ANTERIOR TRACHEOPEXY EXTERNAL SPLINTING TRACHEAL AND BRONCHIAL STENTS TRACHEAL TRANSPLANTATION ASSOCIATED VASCULAR ANOMALIES PULMONARY ARTERY SLING CIRCUMFLEX AORTA RIGHT AORTIC ARCH AND MIDLINE DESCENDING THORACIC AORTA SUMMARY REFERENCES 118 Patent Ductus Arteriosus, Coarctation of the Aorta, and Vascular Rings INTRODUCTION GENERAL SURGICAL APPROACH THORACOTOMY VIDEO-ASSISTED THORACOSCOPIC SURGERY PATENT DUCTUS ARTERIOSUS INTRODUCTION PATHOPHYSIOLOGY AND NATURAL HISTORY CLINICAL PRESENTATION DIAGNOSIS TREATMENT MEDICAL SURGICAL AND TRANSCATHETER Premature Infants Full-Term Infants, Children, and Adults PROGNOSIS COARCTATION OF THE AORTA INTRODUCTION ANATOMY AND PATHOPHYSIOLOGY NATURAL HISTORY CLINICAL PRESENTATION DIAGNOSIS TREATMENT MEDICAL MANAGEMENT SURGICAL REPAIR COARCTATION AND VENTRICULAR SEPTAL DEFECT TRANSCATHETER INTERVENTION POSTOPERATIVE COMPLICATIONS AND PROGNOSIS VASCULAR RINGS, VASCULAR SLINGS, AND VASCULAR COMPRESSION SYNDROMES INTRODUCTION CLASSIFICATION ANATOMY AND PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSIS ADVANCED ASSESSMENT OF ASSOCIATED AIRWAY DISEASE GENERAL TREATMENT/SURGICAL APPROACH GENERAL PROGNOSIS COMPLICATIONS SPECIFIC ARCH ANOMALIES DOUBLE AORTIC ARCH Surgical Approach Outcomes RIGHT AORTIC ARCH WITH (MIRROR-IMAGE BRANCHING OR ABERRANT LEFT SUBCLAVIAN ARTERY) Surgical Approach Outcomes CIRCUMFLEX AORTIC ARCH Surgical Approach Outcomes LEFT AORTIC ARCH AND ANOMALOUS (RETROESOPHAGEAL) RIGHT SUBCLAVIAN ARTERY Surgical Approach Outcomes PULMONARY ARTERY SLING Surgical Approach Outcomes INNOMINATE ARTERY COMPRESSION SYNDROME Surgical Approach Outcomes CERVICAL AORTIC ARCH References 119 Atrial Septal Defect and Cor Triatriatum INTRODUCTION AND HISTORICAL CONTEXT EMBRYOLOGY, ANATOMY, AND GENETICS ATRIAL SEPTATION GENETICS PATENT FORAMEN OVALE SECUNDUM-TYPE ATRIAL SEPTAL DEFECT PRIMUM-TYPE ATRIAL SEPTAL DEFECT SINUS VENOSUS ATRIAL SEPTAL DEFECT ATRIAL SEPTAL ANEURYSM CORONARY SINUS–TYPE ATRIAL SEPTAL DEFECT IATROGENIC AND TRAUMATIC ATRIAL SEPTAL DEFECT EPIDEMIOLOGY INCIDENCE ASSOCIATED FEATURES PATHOPHYSIOLOGY AND NATURAL HISTORY HEMODYNAMICS PULMONARY VASCULAR DISEASE ARRHYTHMIA ENDOCARDITIS CLINICAL PRESENTATION AND DIAGNOSTIC EVALUATION CLINICAL PRESENTATION PHYSICAL EXAM AND DIAGNOSTIC WORK-UP MANAGEMENT OF ATRIAL SEPTAL DEFECT AND PATENT FORAMEN OVALE INDICATIONS AND CONTRAINDICATIONS TO ATRIAL SEPTAL DEFECT CLOSURE PATENT FORAMEN OVALE MANAGEMENT INDICATIONS FOR PATENT FORAMEN OVALE CLOSURE PATENT FORAMEN OVALE AND STROKE PATENT FORAMEN OVALE AND MIGRAINES PATENT FORAMEN OVALE AND DIVER’S DECOMPRESSION ILLNESS CATHETER-BASED TREATMENT SURGICAL TREATMENT SECUNDUM ATRIAL SEPTAL DEFECT and PATENT FORAMEN OVALE SINUS VENOSUS ATRIAL SEPTAL DEFECT WITH PARTIAL ANOMALOUS PULMONARY VENOUS DRAINAGE PRIMUM ATRIAL SEPTAL DEFECT MINIMALLY INVASIVE APPROACHES COMPLICATIONS OF SURGERY OUTCOMES PHYSIOLOGIC CHANGES AFTER ATRIAL SEPTAL DEFECT CLOSURE ADULTS ARRHYTHMIA COR TRIATRIATUM EMBRYOLOGY ASSOCIATED ANOMALIES CLINICAL PRESENTATION PATHOPHYSIOLOGY TREATMENT AND OUTCOMES REFERENCES 120 Surgical Considerations in Pulmonary Vein Anomalies ETIOLOGY PARTIAL ANOMALOUS PULMONARY VENOUS DRAINAGE ANATOMY PRESENTATION PATHOPHYSIOLOGY PREOPERATIVE IMAGING SURGICAL REPAIR PLANNING THE SUPERIOR VENA CAVA CANNULATION MINIMALLY INVASIVE APPROACHES RESULTS SCIMITAR SYNDROME PRESENTATION SURGICAL REPAIR RESULTS AND COMPLICATIONS TOTAL ANOMALOUS PULMONARY VENOUS DRAINAGE ANATOMY SUPRACARDIAC ANATOMY CARDIAC ANATOMY INFRACARDIAC ANATOMY MIXED ANATOMY Presentation PATHOPHYSIOLOGY DIAGNOSTIC TECHNIQUES CHEST RADIOGRAPHY ECHOCARDIOGRAPHY CARDIAC CATHETERIZATION MAGNETIC RESONANCE IMAGING COMPUTED TOMOGRAPHY ANGIOGRAPHY SURGICAL REPAIR IMMEDIATE POSTOPERATIVE CONSIDERATIONS RESULTS SPECIAL CONSIDERATIONS TOTAL ANOMALOUS PULMONARY VENOUS DRAINAGE IN HETEROTAXY PULMONARY VEIN STENOSIS PRIMARY PULMONARY VEIN STENOSIS PULMONARY VEIN STENOSIS FOLLOWING REPAIR IMAGING MODALITIES IN PULMONARY VEIN STENOSIS SURGICAL TREATMENTS OF PULMONARY VEIN STENOSIS HYBRID TREATMENT APPROACHES TO PULMONARY VEIN STENOSIS NEW SURGICAL TREATMENTS OF PULMONARY VEIN STENOSIS MEDICAL TREATMENT OF PULMONARY VEIN STENOSIS FACTORS IN DEVELOPMENT OF PULMONARY VEIN STENOSIS AND IMPLICATIONS FOR FUTURE DIRECTIONS CONCLUSIONS REFERENCES 121 Atrioventricular Canal Defects ANATOMY PATHOPHYSIOLOGY TIMING OF SURGERY COMPLETE ATRIOVENTRICULAR CANAL TRANSITIONAL ATRIOVENTRICULAR CANAL PARTIAL ATRIOVENTRICULAR CANAL OR OSTIUM PRIMUM DEFECTS PREOPERATIVE EVALUATION SURGICAL TECHNIQUE COMPLETE ATRIOVENTRICULAR CANAL DOUBLE-PATCH TECHNIQUE CLASSIC SINGLE-PATCH TECHNIQUE MODIFIED SINGLE-PATCH TECHNIQUE TRANSITIONAL ATRIOVENTRICULAR CANAL PARTIAL ATRIOVENTRICULAR CANAL OR OSTIUM PRIMUM DEFECTS ASSOCIATED CARDIAC LESIONS TETRALOGY OF FALLOT DOUBLE-OUTLET RIGHT VENTRICLE COARCTATION OF THE AORTA LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION TRANSPOSITION OF THE GREAT ARTERIES DOUBLE-ORIFICE MITRAL VALVE PARACHUTE MITRAL VALVE UNBALANCED ATRIOVENTRICULAR CANAL HETEROTAXY SYNDROME SINGLE VENTRICLE RECURRENT MITRAL REGURGITATION POSTOPERATIVE CARE OUTCOMES COMPLETE ATRIOVENTRICULAR CANAL DEFECT PARTIAL ATRIOVENTRICULAR CANAL DEFECT SUMMARY REFERENCES 122 Ventricular Septal Defect and Double-Outlet Right Ventricle VENTRICULAR SEPTAL DEFECT ANATOMY ANATOMY OF THE TRICUSPID VALVE, RIGHT VENTRICULAR SEPTUM, AND CONDUCTION SYSTEM ANATOMIC CLASSIFICATION OF VENTRICULAR SEPTAL DEFECTS Conoventricular (or Membranous) Defects Conal Ventricular Septal Defects Inlet (or Atrioventricular Canal–Type) Ventricular Septal Defects Muscular Ventricular Septal Defects COMMONLY ASSOCIATED CONGENITAL HEART ANOMALIES PATHOPHYSIOLOGY SHUNT DIRECTION AND MAGNITUDE SEQUELAE OF LEFT-TO-RIGHT SHUNTING PULMONARY VASCULAR DISEASE NATURAL HISTORY AND INDICATIONS FOR SURGERY DIAGNOSIS AND WORK-UP SURGICAL TECHNIQUE SURGICAL MANAGEMENT OF VENTRICULAR SEPTAL DEFECT WITH ASSOCIATED ANOMALIES POSTOPERATIVE CARE RESULTS OF SURGICAL TREATMENT Early Results Late Results DOUBLE-OUTLET RIGHT VENTRICLE WITH NORMALLY RELATED GREAT ARTERIES CLASSIFICATION OF DORV BY VSD LOCATION AND OTHER ANATOMIC DETERMINANTS OF PHYSIOLOGY OTHER IMPORTANT ANATOMIC FEATURES AND THEIR IMPACT ON THE TYPE OF REPAIR DISTANCE BETWEEN TRICUSPID AND PULMONARY VALVE CONAL SEPTUM PULMONARY OUTFLOW TRACT OBSTRUCTION CORONARY ARTERY ANATOMY GREAT ARTERY RELATIONSHIP PREOPERATIVE EVALUATION SURGICAL MANAGEMENT INTRAVENTRICULAR REPAIR OF DORV WITH SUBAORTIC VSD OR DOUBLY COMMITTED VSD WITHOUT PULMONARY STENOSIS INTRAVENTRICULAR REPAIR OF DORV WITH SUBAORTIC VSD OR DOUBLY COMMITTED VSD WITH PULMONARY STENOSIS REPAIR OF DORV WITH NONCOMMITTED VSD REPAIR OF DORV WITH SUBPULMONARY VSD RESULTS OF SURGICAL TREATMENT REFERENCES 123 Pulmonary Atresia With Intact Ventricular Septum INTRODUCTION ANATOMY PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSIS AND IMAGING INITIAL MANAGEMENT AND STABILIZATION SURGICAL MANAGEMENT INITIAL PALLIATION DEFINITIVE REPAIR TECHNIQUES BIVENTRICULAR REPAIR HYBRID (1.5-VENTRICLE) REPAIR STAGED SINGLE-VENTRICLE PALLIATION ADDITIONAL SURGICAL CONSIDERATIONS SUMMARY OF OUR INSTITUTIONAL APPROACH TO SURGICAL MANAGEMENT SURGICAL OUTCOMES SUMMARY AND CONCLUSIONS REFERENCES 124 Tetralogy of Fallot With Pulmonary Stenosis HISTORY PREVALENCE AND ETIOLOGY ANATOMY AND PHYSIOLOGY PULMONARY VALVE AND PULMONARY VALVE ANNULUS VENTRICULAR SEPTAL DEFECT AORTIC OVERRIDING MAIN PULMONARY ARTERY AND BRANCH PULMONARY ARTERIES CORONARY ARTERIES PHYSICAL EXAMINATION MEDICAL MANAGEMENT DIAGNOSTIC STUDIES SURGICAL TREATMENT PALLIATIONS REPAIR Anesthetic Management Surgical Access SPECIAL TOPICS IN SURGICAL MANAGEMENT PRESERVATION OF THE PULMONARY VALVE USE OF A MONOCUSP FOR THE RECONSTRUCTION OF THE RIGHT VENTRICULAR OUTFLOW TRACT ANOMALOUS CORONARY PATTERNS CONTROVERSIES IN SURGICAL MANAGEMENT TIMING OF OPERATION VENTRICULOTOMY VERSUS TRANSATRIAL–TRANSPULMONARY APPROACH POSTOPERATIVE MANAGEMENT LONG-TERM FOLLOW-UP RIGHT VENTRICULAR PERFORMANCE AND FUNCTIONAL STATUS ARRHYTHMIAS AND SUDDEN DEATH LATE PULMONARY VALVE IMPLANTATION ATRIOVENTRICULAR SEPTAL DEFECT AND TETRALOGY OF FALLOT TETRALOGY OF FALLOT WITH ABSENT PULMONARY VALVE ACKNOWLEDGMENT REFERENCES 125 Pulmonary Atresia With Ventricular Septal Defect and Right Ventricle-to-Pulmonary Artery Conduits PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT ANATOMY AND PATHOPHYSIOLOGY CLASSIFICATION NATURAL HISTORY CLINICAL PRESENTATION DIAGNOSTIC STUDIES INITIAL STUDIES CARDIAC CATHETERIZATION AXIAL IMAGING RADIONUCLIDE LUNG PERFUSION SCANNING MEDICAL TREATMENT SURGICAL TREATMENT CONFLUENT CENTRAL PULMONARY ARTERIES WITHOUT MAJOR AORTOPULMONARY COLLATERAL ARTERIES HYPOPLASTIC CENTRAL PULMONARY ARTERIES WITH MAJOR AORTOPULMONARY COLLATERAL ARTERIES ABSENT CENTRAL PULMONARY ARTERIES WITH MAJOR AORTOPULMONARY COLLATERAL ARTERIES SINGLE-STAGE UNIFOCALIZATION AND COMPLETE REPAIR MULTIPLE-STAGE REPAIR STRATEGY TRANSPLANTATION TECHNICAL CONSIDERATIONS CARDIOPULMONARY BYPASS STRATEGY CLOSURE OF VENTRICULAR SEPTAL DEFECT RIGHT VENTRICLE-TO-PULMONARY ARTERY CONDUIT TRANSANNULAR PATCH MAINTENANCE OF PATENT FORAMEN OVALE AORTOPULMONARY SHUNTING SINGLE-STAGE UNIFOCALIZATION MULTIPLE-STAGE UNIFOCALIZATION POSTOPERATIVE ASSESSMENT AND MANAGEMENT RESULTS CONCLUSION RIGHT VENTRICLE-TO-PULMONARY ARTERY CONDUITS INTRODUCTION CHOICE OF CONDUIT ALLOGRAFT XENOGRAFT AUTOLOGOUS TISSUE SYNTHETIC CONDUITS Nonvalved Valved RESULTS CONDUIT LOCATION CONDUIT REPLACEMENT OR RECONSTRUCTION TECHNICAL CONSIDERATIONS RESULTS REFERENCES 126 Truncus Arteriosus and Aortopulmonary Window TRUNCUS ARTERIOSUS EMBRYOLOGY ANATOMY ASSOCIATED ANOMALIES PATHOPHYSIOLOGY DIAGNOSIS CLINICAL FEATURES DIAGNOSTIC STUDIES NATURAL HISTORY TREATMENT SURGICAL TECHNIQUE OTHER SURGICAL CONSIDERATIONS INTERRUPTED AORTIC ARCH TRUNCAL VALVE REGURGITATION OR STENOSIS PULMONARY OUTFLOW TRACT RECONSTRUCTION POSTOPERATIVE MANAGEMENT RESULTS AORTOPULMONARY WINDOW EMBRYOLOGY ANATOMY ASSOCIATED ANOMALIES PATHOPHYSIOLOGY DIAGNOSIS CLINICAL FEATURES DIAGNOSTIC STUDIES NATURAL HISTORY HISTORICAL SURGICAL TECHNIQUE MEDICAL TREATMENT SURGICAL TECHNIQUE OTHER SURGICAL CONSIDERATIONS INTERVENTIONAL TECHNIQUES POSTOPERATIVE MANAGEMENT RESULTS REFERENCES 127 Interrupted Aortic Arch HISTORICAL NOTES EMBRYOLOGY AND ANATOMY PATHOPHYSIOLOGY AND CLINICAL PRESENTATION DIAGNOSIS AND IMAGING PREOPERATIVE CONSIDERATIONS DECISION MAKING OPERATIVE MANAGEMENT MONITORING APPROACH CANNULATION AND MANAGEMENT OF CARDIOPULMONARY BYPASS MYOCARDIAL PROTECTION PRIMARY CARDIAC REPAIR Ventricular Septal Defect Patch-Closure Aortic Arch Repair YASUI OPERATION ROSS-KONNO OPERATION STAGED APPROACH HYBRID PALLIATION POSTOPERATIVE COMPLICATIONS OUTCOMES EARLY SURVIVAL LATE SURVIVAL REOPERATIONS Left Ventricle Outflow Tract Obstruction Aortic Arch Left Bronchial Compression SUMMARY REFERENCES 128 Surgery for Congenital Anomalies of the Aortic Valve and Aortic Root INTRODUCTION SURGICAL ANATOMY OF THE AORTIC VALVE AND ROOT DIAGNOSTIC APPROACH TO CONGENITAL ANOMALIES OF THE AORTIC VALVE AND AORTIC ROOT ECHOCARDIOGRAPHY STRESS TESTING CARDIAC CATHETERIZATION COMPUTED TOMOGRAPHY AORTIC STENOSIS VALVULAR AORTIC STENOSIS PREVALENCE AND NATURAL HISTORY CLINICAL PRESENTATION AND DIAGNOSIS TREATMENT Catheter Versus Surgical Relief of Aortic Stenosis in the Neonate MANAGEMENT OF AORTIC STENOSIS IN INFANCY Aortic Stenosis in the Older Child SUBVALVULAR AORTIC STENOSIS SUBAORTIC MEMBRANE (DISCRETE) NATURAL HISTORY AND SURGICAL INDICATIONS SURGICAL APPROACH SURGICAL RESULTS TUNNEL-LIKE SUBAORTIC STENOSIS KONNO-RASTAN AORTOVENTRICULOPLASTY Surgical Indications Surgical Approach Surgical Results MODIFIED KONNO OPERATION Surgical Indications Surgical Approach Surgical Results ROSS-KONNO OPERATION APICO-AORTIC CONDUIT HYPERTROPHIC CARDIOMYOPATHY SURGICAL INDICATIONS PREOPERATIVE ASSESSMENT SURGICAL APPROACH SURGICAL RESULTS SUPRAVALVULAR AORTIC STENOSIS CLINICAL PRESENTATION ANESTHETIC CONSIDERATIONS SURGICAL INDICATIONS SURGICAL APPROACH RESULTS AORTIC REGURGITATION PRIMARY CONGENITAL AORTIC VALVE REGURGITATION AORTIC REGURGITATION ASSOCIATED WITH A VENTRICULAR SEPTAL DEFECT AORTIC REGURGITATION FOLLOWING BALLOON DILATION FOR AORTIC STENOSIS AORTIC REGURGITATION ASSOCIATED WITH A CONNECTIVE TISSUE DISEASE AORTIC VALVE RECONSTRUCTIVE TECHNIQUES AORTIC VALVE LEAFLET PROLAPSE AORTIC VALVE LEAFLET EXTENSIONS BICUSPIDIZATION AORTIC VALVE NEOCUSPIDIZATION AORTIC VALVE REPLACEMENT AORTIC VALVE REPLACEMENT COMPARING MECHANICAL AND BIOLOGIC PROSTHESES HOMOGRAFT AORTIC VALVE REPLACEMENT ROSS OPERATION CONTRAINDICATIONS TO THE ROSS OPERATION MECHANICAL PROSTHESES, ANTICOAGULATION, AND PREGNANCY SUMMARY REFERENCES 129 Surgery for Congenital Anomalies of the Coronary Arteries ANOMALOUS ORIGIN OF A CORONARY ARTERY FROM THE PULMONARY ARTERY ANATOMY PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSTIC IMAGING SURGICAL MANAGEMENT INDICATIONS FOR SURGERY SURGICAL TECHNIQUES Coronary Artery Bypass Grafting Direct Reimplantation Modified Takeuchi Operation POSTOPERATIVE MANAGEMENT RESULTS SPECIAL CONSIDERATIONS MITRAL REGURGITATION LATE PRESENTATION OUTSIDE OF INFANCY ANOMALOUS AORTIC ORIGIN OF THE CORONARY ARTERY ANATOMY PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSTIC IMAGING SURGICAL MANAGEMENT INDICATIONS FOR SURGERY SURGICAL TECHNIQUES Unroofing Procedure Creation of a Neo-Ostium Other Techniques SURGICAL RESULTS CORONARY ARTERY FISTULA ANATOMY PATHOPHYSIOLOGY CLINICAL PRESENTATION NATURAL HISTORY DIAGNOSTIC IMAGING INDICATIONS FOR CLOSURE SURGICAL MANAGEMENT INDICATIONS FOR SURGERY SURGICAL TECHNIQUES SURGICAL RESULTS CONGENITAL OSTIAL ATRESIA OF THE LEFT MAIN CORONARY ARTERY ANATOMY PATHOPHYSIOLOGY CLINICAL PRESENTATION DIAGNOSTIC IMAGING SURGICAL MANAGEMENT Surgical Results REFERENCES 130 Transposition of the Great Arteries: Simple and Complex Forms HISTORY EPIDEMIOLOGY CLASSIFICATION AND EMBRYOLOGY ANATOMY CLINICAL FEATURES DIAGNOSIS PHYSICAL EXAMINATION DIAGNOSTIC STUDIES PREOPERATIVE MEDICAL MANAGEMENT SURGICAL MANAGEMENT SURGICAL CORRECTION PALLIATIVE OPERATIONS ATRIAL REPAIRS OUTCOME AFTER SENNING AND MUSTARD OPERATIONS ARTERIAL REPAIRS TECHNIQUE POSTOPERATIVE MANAGEMENT OUTCOME AFTER ARTERIAL SWITCH OPERATION Early and Mid-Term Follow-Up Late Follow-Up Fate of the Neoaortic Valve and Late Coronary Lesions COMPLEX TRANSPOSITION ANATOMIC VARIANTS OF TRANSPOSITION OF THE GREAT ARTERIES CONAL SEPTUM TRANSPOSITION AND LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION TRANSPOSITION AND RIGHT VENTRICULAR OUTFLOW TRACT OBSTRUCTION DOUBLE-OUTLET RIGHT VENTRICLE WITH TRANSPOSITION CORONARY ARTERY ANATOMY AORTIC ARCH ANATOMY DIAGNOSIS AND PREOPERATIVE MANAGEMENT TRANSPOSITION OF THE GREAT ARTERIES WITH LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION Palliative Procedures Surgical Technique Corrective Procedures TRANSPOSITION OF THE GREAT ARTERIES WITH POSTERIOR DEVIATION OF CONAL SEPTUM Rastelli Operation Aortic Autograft Translocation and Arterial Switch TRANSPOSITION OF THE GREAT ARTERIES WITH DOUBLE-OUTLET RIGHT VENTRICLE Subpulmonary Ventricular Septal Defect Noncommitted Ventricular Septal Defect TRANSPOSITION OF THE GREAT ARTERIES WITH AORTIC ARCH OBSTRUCTION RESULTS TRANSPOSITION OF THE GREAT ARTERIES WITH LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION TRANSPOSITION OF THE GREAT ARTERIES WITH DOUBLE-OUTLET RIGHT VENTRICLE TRANSPOSITION OF THE GREAT ARTERIES WITH AORTIC ARCH OBSTRUCTION ARTERIAL SWITCH AFTER LEFT VENTRICULAR RETRAINING SUMMARY REFERENCES 131 Surgery for Congenitally Corrected Transposition of the Great Arteries INTRODUCTION GENERAL DESCRIPTION AND MORPHOLOGY VENTRICULAR SEPTAL DEFECT PULMONARY OUTFLOW TRACT OBSTRUCTION (MORPHOLOGIC LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION) MITRAL AND TRICUSPID VALVES ARCH ANOMALIES CORONARY ARTERIES CONDUCTION SYSTEM CLINICAL PRESENTATION OF CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT ARTERIES PROBLEM OF THE TRICUSPID VALVE AND THE MORPHOLOGIC RIGHT VENTRICLE IN THE SYSTEMIC CIRCULATION RETRAINING OF THE LEFT VENTRICLE INVESTIGATIONS AND EVALUATION SURGICAL OPTIONS PHYSIOLOGIC REPAIR (CONVENTIONAL OR CLASSIC) CLOSURE OF THE VENTRICULAR SEPTAL DEFECT PLACEMENT OF THE VALVED CONDUIT TRICUSPID VALVE REPAIR OR REPLACEMENT PALLIATIVE SURGICAL PROCEDURES ANATOMIC REPAIR CARDIOPULMONARY BYPASS AND GENERAL CONSIDERATIONS IN ANATOMIC REPAIR SURGICAL ANATOMIC REPAIR OF CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT ARTERIES Atrial-Arterial Switch (Double Switch) Rastelli-Senning Procedure POSTOPERATIVE MANAGEMENT THE ONE-AND-A-HALF REPAIR PULMONARY ARTERY BANDING FONTAN PROCEDURE RESULTS PHYSIOLOGIC REPAIR ANATOMIC REPAIR COMPARISONS OF CONVENTIONAL VERSUS ANATOMIC REPAIR AND THE OUTCOMES OF OTHER APPROACHES SUMMARY REFERENCES 132 Congenital Anomalies of the Mitral Valve EMBRYOLOGY OF THE MITRAL VALVE PATHOLOGIC FEATURES SUPRAVALVAR MITRAL RING CLEFT MITRAL VALVE LESIONS ASSOCIATED WITH LACK OF VALVAR TISSUE PARACHUTE MITRAL VALVE PAPILLARY MUSCLE TO COMMISSURE FUSION HAMMOCK OR ARCADE VALVE ISOLATED MITRAL LEAFLET HYPOPLASIA DILATION OF THE MITRAL VALVE ANNULUS WITH ELONGATION OF THE CHORDS AND PAPILLARY MUSCLE ACCESSORY MITRAL VALVE TISSUE MITRAL VALVE DISEASE WITH EXCESS OF LEAFLET TISSUE, AND MITRAL VALVE PROLAPSE BORDERLINE LEFT VENTRICLE RECURRENT LEFT ATRIOVENTRICULAR VALVE REGURGITATION FUNCTIONAL CLASSIFICATION OF MITRAL VALVE ANOMALIES DIAGNOSIS CLINICAL EXAMINATION ELECTROCARDIOGRAPHY AND CHEST RADIOGRAPHY ECHOCARDIOGRAPHY OTHER INVESTIGATION TECHNIQUES MEDICAL TREATMENT SURGICAL TREATMENT MITRAL VALVE REPLACEMENT MITRAL VALVE REPAIR CORRECTION OF TYPE I: REMODELING ANNULOPLASTY CORRECTION OF TYPE II CORRECTION OF TYPE III Mobilization of Papillary Muscles Enlargement of Valvar Leaflet With Pericardium Patch Resection of Supravalvar Rings and Accessory Mitral Valve Tissue Borderline Small Left Ventricle Repair of Recurrent Left Atrioventricular Valve Regurgitation RESULTS MITRAL VALVE STENOSIS AND PREDOMINANT STENOTIC VALVES MITRAL VALVE INSUFFICIENCY AND PREDOMINANT REGURGITANT VALVES RECURRENT LEFT ATRIOVENTRICULAR VALVE REGURGITATION References 133 Hypoplastic Left Heart Syndrome INTRODUCTION HISTORICAL PERSPECTIVES ANATOMY COMMON ANATOMIC FEATURES ADDITIONAL ANATOMIC FEATURES ETIOLOGY EPIDEMIOLOGY FETAL EVALUATION AND PRENATAL MANAGEMENT DIAGNOSTICS FETAL INTERVENTIONS MATERNAL INTERVENTIONS NEONATAL EVALUATION AND MANAGEMENT PARALLEL CIRCULATION IMMEDIATE MEDICAL MANAGEMENT AT BIRTH HYPOPLASTIC LEFT HEART SYNDROME WITH INTACT OR RESTRICTIVE ATRIAL SEPTUM SURGICAL PALLIATION STAGE 1 PALLIATION PREOPERATIVE PREPARATION INTRAOPERATIVE MANAGEMENT SURGICAL TECHNIQUES THE RIGHT VENTRICLE TO PULMONARY ARTERY SHUNT VERSUS THE MODIFIED BLALOCK-TAUSSIG-THOMAS SHUNT HYBRID PALLIATION EARLY POSTOPERATIVE MANAGEMENT MECHANICAL CIRCULATORY SUPPORT AFTER STAGE 1 OUTCOMES OF STAGE 1 AND INTERSTAGE PERIOD STAGE 2 PALLIATION TIMING AND PREOPERATIVE ASSESSMENT SURGICAL TECHNIQUES OUTCOMES OF STAGE 2 STAGE 3 PALLIATION TIMING AND PREOPERATIVE ASSESSMENT EXTRACARDIAC CONDUIT VERSUS LATERAL TUNNEL Fontan FENESTRATION SURGICAL TECHNIQUES CATHETER-BASED ALTERNATIVES OUTCOMES OF STAGE 3 PALLIATION TRICUSPID VALVE INSUFFICIENCY PRIMARY TRANSPLANTATION AS ALTERNATIVE TO STAGED PALLIATION FAILING Fontan MANAGEMENT CONCLUSIONS Acknowledgment REFERENCES 134 Management of Single Ventricle and Cavopulmonary Connections INTRODUCTION ANATOMY NATURAL HISTORY EPIDEMIOLOGY THE SINGLE VENTRICLE JOURNEY SINGLE VENTRICLE PHYSIOLOGY AND OPTIMIZATION FROM BIRTH INSUFFICIENT PULMONARY BLOOD FLOW EXCESSIVE PULMONARY BLOOD FLOW CONCOMITANT LESIONS NONCARDIAC ANOMALIES BIDIRECTIONAL CAVOPULMONARY SHUNT (BIDIRECTIONAL GLENN) TIMING CONCOMITANT LESIONS SURGICAL TECHNIQUE ALTERNATIVES AND ADAPTATIONS SURGICAL EVOLUTION OF THE FONTAN PROCEDURE ATRIOPULMONARY FONTAN AND BJÖRK MODIFICATION LATERAL TUNNEL EXTRACARDIAC CONDUIT FENESTRATION FONTAN PATIENT SELECTION AND OPTIMIZATION OPERATIVE CONSIDERATIONS OUTCOMES OF SINGLE VENTRICLE PALLIATION MORTALITY PRIOR TO FONTAN EARLY OUTCOMES AND PERIOPERATIVE MANAGEMENT AFTER THE FONTAN PROCEDURE EARLY FAILURE AND FONTAN TAKEDOWN LONG-TERM SURVIVAL AND LATE FONTAN FAILURE ATRIOVENTRICULAR VALVE REGURGITATION ARRHYTHMIAS THROMBOEMBOLISM LYMPHATIC DYSFUNCTION: PROTEIN-LOSING ENTEROPATHY AND PLASTIC BRONCHITIS END-ORGAN DYSFUNCTION GENERAL HEALTH, DEVELOPMENT, AND WELL-BEING SURGICAL MANAGEMENT OF LATE FONTAN FAILURE FONTAN CONVERSION MECHANICAL SUPPORT AND TRANSPLANTATION FUTURE PERSPECTIVES REFERENCES 135 Ebstein Malformation HISTORICAL ASPECTS PATHOLOGIC ANATOMY TRICUSPID VALVE RIGHT VENTRICLE ASSOCIATED CARDIAC DEFECTS CLASSIFICATIONS OF EBSTEIN MALFORMATION GENETIC FACTORS PATHOPHYSIOLOGY CLINICAL PRESENTATIONS SYMPTOMS CYANOSIS AND HEART FAILURE EXERTIONAL DYSPNEA, FATIGUE, CYANOSIS, AND PALPITATIONS PALPITATIONS PARADOXICAL EMBOLIZATION PHYSICAL EXAMINATION DIAGNOSTIC WORK-UP CHEST RADIOGRAPHY ELECTROCARDIOGRAPHY ECHOCARDIOGRAPHY CARDIAC CATHETERIZATION MAGNETIC RESONANCE IMAGING NATURAL HISTORY MANAGEMENT NEONATES AND INFANTS INDICATIONS FOR OPERATION Biventricular Repair (Knott-Craig Approach) Right Ventricular Exclusion (Starnes Approach) Modified Starnes Approach (Total Ventricular Exclusion) Heart Transplantation CHILDREN AND ADULTS INDICATIONS FOR OPERATION OPERATIVE MANAGEMENT Cone Repair Adjuncts to Cone Repair Tricuspid Valve Re-Repair Tricuspid Valve Replacement The 1.5-Ventricle Repair Surgical Treatment of Arrhythmias Heart Transplantation POSTOPERATIVE CARE OUTCOMES REFERENCES 136 Adult Congenital Cardiac Surgery BACKGROUND SURGICAL DECISION MAKING PREOPERATIVE EVALUATION NON-CARDIAC SEQUELAE OF CONGENITAL HEART DISEASE RENAL SEQUELAE HEMATOLOGIC SEQUELAE PULMONARY SEQUELAE HEPATIC SEQUELAE NEUROLOGIC AND PSYCHOSOCIAL SEQUELAE VASCULAR SEQUELAE PERIOPERATIVE MANAGEMENT STERNAL REENTRY PROTOCOL MANAGEMENT OF BLEEDING DURING RESTERNOTOMY POSTOPERATIVE MANAGEMENT SPECIFIC LESIONS ATRIAL SEPTAL DEFECT SINUS VENOSUS DEFECT VENTRICULAR SEPTAL DEFECT ATRIOVENTRICULAR CANAL DEFECT AORTIC VALVE STENOSIS OR REGURGITATION CORONARY ARTERY ABNORMALITIES TETRALOGY OF FALLOT EBSTEIN ANOMALY SINGLE VENTRICLE AND FONTAN PHYSIOLOGY INFECTIVE ENDOCARDITIS SUMMARY REFERENCES 137 Quality Improvement: Surgical Performance BACKGROUND DEVELOPMENT OF THE TECHNICAL PERFORMANCE SCORE PILOTING THE TECHNICAL PERFORMANCE SCORE STANDARDIZATION OF METHODOLOGY VALIDATION OF TECHNICAL PERFORMANCE SCORE PROCEDURE-BASED VALIDATION OF TECHNICAL PERFORMANCE SCORE PROSPECTIVE VALIDATION OF TECHNICAL PERFORMANCE SCORE FUTURE DIRECTION REFERENCES
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