The sixth edition of this acclaimed and established operative atlas continues to provide a unique level of comprehensive detail on operative surgery of the heart and great vessels.


With an international list of authors, the chapters have been updated and complemented by the same high quality artwork that has established this operative guide as the gold standard reference for the cardiac surgeon. 


This new edition retains the format of initial principles and justification for the procedure, followed by preoperative investigations and preparation, the operative procedure, and postoperative management. New chapters have been added on the latest techniques such as minimal invasive surgery, robotic surgery and off-pump bypass surgery.


The chapters are arranged in seven sections, with each section emphasising the overall management of patients, tricks of the trade of individual authors and discussion of technical and clinical judgement. 


With this new and updated edition, Operative Cardiac Surgery remains the pre-eminent operative guide to a full range of cardiac conditions.

Section One Perioperative Management. Echocardiography for Cardiac Surgery. Cardiopulmonary Bypass: Access, Technical Options and Pathophysiology. Circulatory Arrest: Retrograde vs Antegrade Cerebral Protection. Intraoperative Myocardial Protection. Section Two Surgery for Ischemic Heart Disease. On Pump Coronary Artery Bypass Grafting. Off-pump coronary artery bypass grafting. Expanded use of Arterial Conduits. Reoperative Coronary Artery Bypass Grafting. Repair of Postinfarction Ventricular Septal Defect. Robotic total endoscopic coronary artery bypass grafting (TECAB) Section Three Surgery for Valvular Heart Disease. Aortic valve replacement. Minimal Access Aortic Valve Surgery. TAVR: Transfemoral and Alternative Approaches. Aortic Valve Repair. Mitral Valve Replacement. Mitral Valve Repair. Minimal access Mitral Valve Surgery. Robot-Assisted Mitral Valve Surgery. Tricuspid Valve Surgery. The Pulmonary Autograft for Aortic Valve Replacement. Valvular Endocarditis. Valve Sparing Aortic Root Replacement. Section Four Surgery for Heart Failure.Heart Transplantation. Heart- Lung Transplantation. Lung Transplantation. Permanent continuous flow left ventricular assist devices. Temporary Mechanical Assistance (ECMO). Left Ventricular Reconstruction. Surgery for Hypertrophic Cardiomyopathy. Standard Surgical Therapies for CHF/MVR for Heart Failure. Section Five Thoracic Aortic Disease. Ascending Aortic Aneurysm. Hybrid aortic arch repair. Thoracoabdominal aortic aneurysms. Thoracic Endovascular Aortic Repair. Aortic Dissection: Type A and B. Section Six Surgery for Cardiac Rhythm Disorders & Tumors. The Cut-and-Sew Maze-III Procedure for the Treatment of Atrial Fibrillation. Cardiac Tumors. Pacers and BV Pacers. Section Seven Surgery for Congenital Heart Disease. The Anatomy of Congenital Cardiac Malformations. Palliative procedures: Shunts and pulmonary artery banding. Total anomalous pulmonary venous connection and cortriatriatum. Atrial septal defect. Atrioventricular septal defect. Bidirectional Glenn and hemi-Fontan procedures. Fontan procedure for functionally single ventricle and double-inlet ventricle. Double-outlet ventricles. Ebstein's anomaly. Ventricular septal defect. Tetralogy of Fallot. Pulmonary atresia with ventricular septal defect. Right ventricular outflow tract obstruction with intact ventricular septum. Left ventricular outflow tract obstruction. Transposition of the great arteries with left ventricular outflow tract obstruction. Transposition of the great arteries with right ventricular outflow tract obstruction. Anatomical repair of transposition of the great arteries. Congenitally Corrected Transposition. Persistent truncus arteriosus. Persistent Ductus Arteriosus. Aortopulmonary Window. Coarctation of the aorta: Repair of coarctation and arch interruption. Congenital anomalies of the aortic arch. Hypoplastic left heart syndrome. Coronary anomalies. Cardiac transplantation for congenital heart disease. Lung and heart-lung transplantation for congenital heart disease. Ventricular assist devices for congenital heart disease. Congenital Mitral valve repair. Aortic valve repair.Index


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Surgery to the nasal septum and to the turbinates constitutes a significant part of the workload of an otolaryngologist. The patient invariably experiences short-term nasal obstruction following such surgery and different medications are commonly used to relieve this and to promote a sense of airway patency. However the efficacy of topical and systemic medication, given in the post-operative period is hot well documented. A prospective randomized trial was therefore undertaken to compare the efficacy of a topically applied vasoconstrictor and an anticholinergic agent in reducing the sensation of airway obstruction in the first week following simple nasal airway surgery. 0.5% Ephedrine hydrochloride nasal drops, Pseudoephedrine tablets and a combination of the two were compared to a control group who received no treatment. Eighty patients were randomised into four groups and nasal patency assessed by patients using a visual analogue sacle (VAS). When compared to the control group both medications were effective in relieving nasal congestion but a combination of topical and systemic therapy, given together, was superior to either agent used alone. The results achieved were independent of the seniority of the surgeon undertaking the operation.

Franz Omar Smith, MD, FACS, is a fellowship trained surgeon certified in advanced complex surgical oncology and general surgery. He has expertise in cutaneous oncology and sarcoma, as well as breast cancer. Dr. Smith sees patients at Cooperman Barnabas Medical Center, Clara Maass Medical Center, and Jersey City Medical Center. He embraces the multi-disciplinary approach to cancer care at RWJBarnabas Health by providing an individualized treatment plan for each of his patients. During his residency Dr. Smith completed a three-year clinical research fellowship in Tumor Immunotherapy and Surgical Oncology in the Surgery Branch at the National Cancer Institute, part of the National Institutes of Health. The focus of his research was on high dose Interleukin-2, tumor vaccines and cell-based therapies for the treatment of metastatic melanoma. Upon graduation from residency he completed a two-year surgical oncology fellowship at the H. Lee Moffitt Cancer Center/ University of South Florida in Tampa, FL.

Dr. Brian M. Smith is board certified in surgery and specializes in general surgery, including robotic-assisted and laparoscopic hernia and reflux surgery, gallbladder procedures and robotic single-incision cholecystectomy.

Well, there is a new tome in town, and it certainly looks different. There is continuation of the editorial lineage via London and Michigan. It is strikingly colourful with, as before, an accent on illustrated operative steps but with the addition of photographs of pathology and radiographs to give it a little perspective and context. It is though, noticeably smaller, but perhaps still not quite ready for the pocket yet.

Summary of background data:  The Scoliosis Research Society-Schwab classification offers a framework for defining alignment in patients with ASD. Although age-specific changes in spinal alignment and patient-reported outcomes have been established in the literature, their relationship in the setting of ASD operative realignment has not been reported.

Methods:  ASD patients who received operative or nonoperative treatment were consecutively enrolled. Patients were stratified by age, consistent with published US-normative values (Norms) of the SF-36 PCS (75 y old). At baseline, relationships between between radiographic spino-pelvic parameters (lumbar-pelvic mismatch [PI-LL], pelvic tilt [PT], sagittal vertical axis [SVA], and T1 pelvic angle [TPA]), age, and PCS were established using linear regression analysis; normative PCS values were then used to establish age-specific targets. Correlation analysis with ODI and PCS was used to determine age-specific ideal alignment.

Results:  Baseline analysis included 773 patients (53.7 y old, 54% operative, 83% female). There was a strong correlation between ODI and PCS (r = 0.814, P < 0.001), allowing for the extrapolation of US-normative ODI by age group. Linear regression analysis (all with r > 0.510, P < 0.001) combined with US-normative PCS values demonstrated that ideal spino-pelvic values increased with age, ranging from PT = 10.9 degrees, PI-LL = -10.5 degrees, and SVA = 4.1 mm for patients under 35 years to PT = 28.5 degrees, PI-LL = 16.7 degrees, and SVA = 78.1 mm for patients over 75 years. Clinically, older patients had greater compensation, more degenerative loss of lordosis, and were more pitched forward.

Conclusion:  This study demonstrated that sagittal spino-pelvic alignment varies with age. Thus, operative realignment targets should account for age, with younger patients requiring more rigorous alignment objectives.

Dr. Ann DeBord Smith [she/her/hers], is board certified in General Surgery, Director of Bariatric Surgery, and Instructor at Harvard Medical School.


Medical School: University of Chicago Pritzker School of Medicine, MD, 2010

Residency: Brigham & Women&apos;s Hospital, General Surgery, 2018

Fellowship: University of Massachusetts, Advanced Minimally Invasive and Bariatric Surgery, 2019

Board Certification: Board Certified in General Surgery


Dr. Smith&apos;s clinical interests include surgical treatment for Obesity and Reflux disease as well as minimally invasive approaches to general surgery such as hernias and colorectal disease. In the surgeon&apos;s spare time she enjoys biking and running with her family.

bariatric surgery, gastroesophageal reflux disease (GERD), gastrointestinal oncology, hernia surgery, laparoscopic endocrine surgery, laparoscopic gastrointestinal surgery, robot-assisted gastrointestinal surgery e24fc04721

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