KEY TOPICS IN CARDIAC SURGERY T The KEY TOPICS SeriesT Advisors:T T TMT Craft T DepartmentT of Anaesthesia and Intensive Care, Royal United Hospital, Bath, UKT CST Garrard T IntensiveT Therapy Unit, John Radcliffe Hospital, Oxford, UKT PMT Upton T DepartmentT of Anaesthesia, Royal Cornwall Hospital, Treliske, Truro, UKT AccidentT and Emergency Medicine, Second EditionT Anaesthesia;T Clinical Aspects, Third EditionT CardiovascularT Medicine T ChronicT Pain, Second EditionT CriticalT CareT Evidence-BasedT MedicineT GastroenterologyT T GeneralT SurgeryT NeonatologyT T NeurologyT T ObstetricsT and Gynaecology, Second EditionT OncologyT T Ophthalmology,T Second EditionT OralT and Maxillofacial SurgeryT OrthopaedicT SurgeryT OrthopaedicT Trauma SurgeryT Otolaryngology,T Second EditionT Paediatrics,T Second EditionT PsychiatryT T RenalT MedicineT RespiratoryT MedicineT ThoracicT SurgeryT TraumaT T ForthcomingT titles include:T CriticalT Care, Second EditionT Neonatology,T Second Edition T PlasticT and Reconstructive SurgeryT SexualT HealthT T KEY TOPICS IN CARDIAC SURGERY T SunilT K OhriT MDT FRCS(Eng, Ed & C-Th) FESCT TConsultant Cardiac Surgeon Wessex Cardiothoracic Centre Southampton General Hospital and Honorary Senior Lecturer University of Southampton Southampton, UKT AugustineT TangT BMedSc(Hon)T DM FRCS(Ed & C-Th) FETCST TConsultant Cardiothoracic Surgeon Blackpool Victoria Hospital Whiney Heys Road Blackpool UKT LarryT W StephensonT MDT FACC FCCP FACST T Professor of Surgery and Chief, Division of Cardiothoracic Surgery Harper University Hospital Detroit, MI USA Taylor & Francis TaylorT & Francis GroupT LONDONT T ANDT NEW YORKT AT MARTIN DUNITZ BOOKT © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN. 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Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A CIP record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Data available on application ISBN 0-203-53742-4 Master e-book ISBN ISBN 0-203-59721-4 (Adobe e-Reader Format) ISBN 1 85996 033 2 (Print Edition) Distributed in North and South America by Taylor & Francis 2000 NW Corporate Blvd Boca Raton, FL 33431, USA Within Continental USA Tel.: 800 272 7737; Fax.: 800 374 3401 Outside Continental USA Tel.: 561 994 0555; Fax.: 561 361 6018 E-mail: [email protected] TH Distributed in the rest of the world by Thomson Publishing Services Cheriton House North Way Andover, Hampshire SP10 5BE, UK Tel.:+44 (0)1264 332424 E-mail: [email protected] TH Composition by Wearset Ltd, Boldon, Tyne and Wear T CONTENTS ListHT of contributors TH xHT TH AbbreviationsHT TH xxiHT TH PrefaceHT TH xxiiiHT TH 1HT TH PartH A H —FundamentalsH H 1H H CardiacH surgical anatomyH 2HT TH H2H CardiacH surgical physiologyH 19HT TH H3H CardiovascularH pharmacology H 41HT TH H4H Pre-operativeH assessment of cardiac surgical patientsH 47HT TH H5H CardiacH imagingH 50HT TH H6H EchocardiographyH H 54HT TH H7H AnesthesiaH for cardiac surgeryH 59HT TH H8H CardiopulmonaryH bypassH 63HT TH H9H ThermoregulationH in cardiac surgeryH 71HT TH H10H HypothermicH circulatory arrestH 75HT TH H11H MyocardialH preservationH 79HT TH H12H BloodH conservationH 87HT TH H13H CardiacH intensive careH 95HT TH H14H PostoperativeH complicationsH 99HT TH H15H RiskH stratification and performance monitoringH 103HT TH 108HT TH PartH B H —AdultH Cardiac SurgeryH 16H H MyocardialH revascularizationH 109HT TH H17H SurgeryH for complications of ischemic heart diseaseH 140HT TH H18H HeartH valve surgeryH 150HT TH H19H AorticH surgeryH 176HT TH H20H SurgeryH for atrial fibrillationH 192HT TH H21H SurgeryH for pericardial diseaseH 196HT TH H22H SurgeryH for cardiac tumorsH 200HT TH H23H SurgeryH for traumaH 204HT TH H24H PulmonaryH thromboendarterectomyH 216HT TH H25H SurgeryH for heart failureH 220HT TH H26H HeartH transplantationH 243HT TH 253HT TH PartH C H —PediatricH Cardiac SurgeryH 27H H AtrialH septal defectH 254HT TH H28H VentricularH septal defectH 257HT TH H29H AtrioventricularH septal defectH 261HT TH H30H PatentH ductus arteriosusH 265HT TH H31H TricuspidH atresiaH 270HT TH H32H PulmonaryH atresia with intact ventricular septumH 273HT TH H33H TetralogyH of FallotH 277HT TH H34H TheH Fontan circulationH 280HT TH H35H HypoplasticH left heart syndrome H 286HT TH H36H TranspositionH of the great arteriesH 291HT TH H37H DoubleH outlet right ventricleH 298HT TH H38H TruncusH arteriosusH 303HT TH H39H InterruptedH aortic archH 306HT TH 40H H CoarctationH of the aortaH 311HT TH H41H ValvularH disease in childrenH 317HT TH H42H TotalH anomalous pulmonary venous connectionH 321HT TH H43H PalliationH versus correction of congenital heart defectsH 325HT TH IndexH H 329HT TH LIST OF CONTRIBUTORS USA Frank A Baciewicz Wayne State University, Harper Hospital, Detroit, USA Carl L Backer Children’s Memorial Hospital, Chicago, USA Vinay Badhwar University of Michigan Hospital, Ann Arbor, Michigan, USA William Baumgartner Johns Hopkins Hospital, Baltimore, Maryland, USA Jennifer A Berry University of Michigan Hospital, Ann Arbor, Michigan, USA Steven F Bolling University of Michigan Hospital, Ann Arbor, Michigan, USA Charles R Bridges Division of Cardiothoracic Surgery, Pennysylvania Hospital, Philadelphia, USA David G Cable Mayo Clinic, Rochester, Minnesota, USA Rachel H Cohn Division of Cardiothoracic Surgery, Evanston Hospital, Illinois, USA Lori D Conklin Baylor College of Medicine, Houston, USA Delos M Cosgrove Cleveland Clinic Foundation, Cleveland, Ohio, USA Wilson J Couto Texas Heart Institute, Houston, USA Joseph S Coselli Baylor College of Medicine, Houston, USA Richard C Daly Mayo Clinic, Rochester, Minnesota, USA Ralph E Delius Children’s Hospital of Michigan, Detroit, USA Carlos Duran International Heart Institute of Montana, Missoula, USA O Howard Frazier Texas Heart Institute, Houston, USA A Marc Gillinov Cleveland Clinic Foundation, Cleveland, Ohio, USA Igor D Gregoric Texas Heart Institute, Housaton, USA Daniel N Gwan-Nulla Wayne State University, Harper Hospital, Detroit, USA Frank L Hanley Stanford University School of Medicine, California, USA Stuart W Jamieson UCSD Medical Center, San Diego, USA Scott A LeMaire Baylor College of Medicine, Houston, USA Constantine Mavroudis Children’s Memorial Hospital, Chicago, USA Derlis Martino Wayne State University, Harper Hospital, Detroit, USA Alberto Pochettino University of Pennsylvania Medical Center, Philadelphia, USA V Mohan Reddy Stanford University School of Medicine, California, USA Mark D Rodefeld James Whitcomb Riley Hospital for Children, Indianapolis, USA Todd K Rosengart Division of Cardiothoracic Surgery, Evanston Hospital, Illinois, USA Irving Shen Doernbecher Children’s Hospital, Oregon Health Sciences University, USA Larry W Stephenson Wayne State University, Harper Hospital, Detroit, USA R Scott Stuart Mid America Thoracic and Cardiovascular Surgery, Kansas City, Missouri, USA James G Tyburski Wayne State University, Detroit Receiving Hospital, Detroit, USA Ross M Ungerleider Doernbecher Children’s Hospital, Oregon Health Sciences University, USA Henry L Walters III Children’s Hospital of Michigan, Detroit, USA Robert F Wilson Wayne State University, Detroit Receiving Hospital, Detroit, USA UK and Europe Kyriakos Anastasiadis Oxford Heart Centre, John Radcliffe Hospital, UK Robert H Anderson Institute of Child Health, University College London, UK Gianni D Angelini Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, UK Ani C Anyanwu Harefield Hospital, London, UK Raimondo Ascione Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, UK George Asimakopoulos Imperial School of Medicine, Hammersmith Hospital, London, UK Emma J Birks Harefield Hospital, London, UK Robert S Bonser Department of Cardiac Surgery, Queen Elizabeth Medical Centre, Birmingham, UK William Brawn Department of Cardiac Surgery, Diana Princess of Wales Children’s Hospital, Birmingham, UK Gareth Charlton Department of Anaethesia, Southampton, General Hospital, UK Gordon A Cohen Great Ormond Street Hospital, London, UK Andrew Cook Institute of Child Health, University College London, UK Malcolm Dalrymple-Hay Plymouth Hospitals NHS Trust, Derriford Hospital, UK Keith D Dawkins Department of Cardiology, Southampton, General Hospital, UK Charles D Deakin Department of Anaesthesia, Southampton, General Hospital,