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Preface
Coronary artery bypass graing (CABG) is now entering its sixth
decade and remains one of the most commonly performed operations worldwide. CABG still accounts for approximately 60% of all
adult cardiac surgery operations, and no other surgical procedure
has been subjected to the same degree of scientic scrutiny.
e future of CABG seems assured at least over the intermediate
term as recent randomized trials conrm it to be the superior treatment for most forms of multi-vessel and/or le main coronary artery disease that requires intervention. Over the longer-term and
in comparison to percutaneous coronary intervention (PCI), even
using the most advanced stents, CABG improves survival and reduces the incidence of myocardial infarction and the need for repeat
revascularization with either no or a minimal increase in the risk of
stroke. e benets of CABG are even greater in patients with diabetes which is becoming endemic in many geographical areas. e
most plausible explanation for the benets of CABG over PCI are
that bypass gras to the mid-distal coronary vessel not only obviate
the relevance of proximal coronary artery disease (irrespective of
its complexity) but also oer prophylaxis against further development or progression of atherosclerotic disease anywhere proximal to
the insertion of a bypass gra. In contrast, even the most advanced
stent technology can only address ow-limiting proximal lesions
and cannot protect against further disease development proximal to,
within, or distal to the stent.
However, unlike PCI and even other surgical procedures, potential technical advances in the performance of CABG have not been
widely adopted. Over the last half century, the standard approach
to CABG has remained the use of a single internal thoracic artery
plus supplemental vein gras (that still account for around 80% of
all bypass gras) performed with cardiopulmonary bypass, aortic
clamping, and cardioplegic arrest. While this remains an excellent
operation with proven durable results in many patients it is not always the best option for all patients.
Despite a large body of evidence proving the long-term angiographic superiority of arterial gras compared to vein gras, on
a worldwide basis fewer than 10% of patients receive more than a
single arterial gra. Similarly, despite the potential advantages of
o-pump CABG and the minimization/elimination of aortic manipulation for certain groups of patients its uptake has remained
low and may be actually be declining. Indeed, minimally invasive,
robotic and endoscopic CABG techniques have remained a tiny
‘niche’ market. Intraoperative quality assessment of bypass gras
during CABG procedures remains relatively uncommon worldwide;
CABG is literally the only vascular surgical procedure that does not
routinely entail a completion angiography or other imaging study
to document the quality of revascularization. In stark contrast, percutaneous coronary intervention (PCI) has witnessed an explosion
in stent technologies and implantation techniques that have been
eagerly adopted by interventional cardiologists, resulting in improved outcomes aer PCI. And, until relatively recently, CABG
has not attracted the same level of interest at major cardiac surgery
scientic meetings as much less commonly performed operations.
However, this situation is changing as there is now increasing recognition of CABG as a specialty in its own right. While the Japanese
have had an association and annual meeting dedicated to coronary
artery surgery for 25 years, the inaugural annual International
Coronary Congress was held in 2015.
Simultaneously, in adult cardiac surgery the role of the super specialist is increasingly recognized. While there is no longer any debate
over whether there should be specialist surgeons and/or specialist
centres for mitral valve repair, complex aortic surgery, or mechanical support and transplantation, until relatively recently, coronary
revascularization operations were frequently regarded as ‘just another CABG’ that can be performed by any cardiac surgeon.
Of course, this attitude was, in reality, always a paradox. From a
technical perspective CABG is more challenging than most other
cardiac surgery operations as the technical margin for error in a
coronary anastomosis (<0.1 mm) is much less than that for most
other operations (<2–5 mm). And while the technical requirements
of CABG increase signicantly for multiple arterial gras and opump procedures, they increase exponentially for minimal access,
robotic, and totally endoscopic procedures. Consequently, there are
increasing calls for the training of super-specialists in CABG. While
not every CABG surgeon may have to be a super-specialist, every
unit performing CABG should have surgeons who routinely perform expert o-pump CABG utilizing techniques that avoid/minimize aortic manipulation and provide every patient with multiple
arterial gras. e availability of surgeons who can routinely perform endoscopic and robotic surgery demands even more sophisticated equipment, training, and logistics.
e current textbook, written by acknowledged experts in their
respective elds, covers all components of surgical myocardial
revascularization with which CABG surgeons and allied practitioners should be familiar. is includes relevant aspects of the
Prefacexii
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pathophysiology and investigation of coronary artery disease, preand postoperative care of CABG patients, the evidence basis and
technical aspects of dierent CABG techniques, and CABG in association with other procedures.
We hope that this book will enable all CABG surgeons and al-
lied practitioners, from trainee to expert, to be comfortable with all
aspects of state-of-the-art surgical coronary revascularization and
narrow the yawning gap between best evidence and common practice in coronary bypass surgery worldwide.
David Taggart
John Puskas
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Contents
Contributors xvii
Abbreviations xxi
SECTION 1
Pathophysiology and investigation of
coronary artery disease
Section editors:Thomas F. Lüscher, Valentin Fuster,
and Prashant Vaishnava
1. A brief history of the surgical treatment
of coronary artery disease 3
Mario Gaudino, Stuart J. Head, and David P. Taggart
2. Epidemiology of ischaemic heart
disease 9
Nick Townsend
3. Pathophysiology of coronary artery
disease 11
3.1 Regulation of coronary flow 11
Nico Bruining, Eric Boersma, and Dirk J. Duncker
3.2 Coronary endothelial function 13
R. Jay Widmer and Amir Lerman
3.3 Coronary artery spasm 16
Hiroaki Shimokawa and Jun Takahashi
3.4 The coronary microcirculation and coronary
microvascular dysfunction 18
Romana Herscovici and C. Noel Bairey Merz
3.5 Plaque rupture and erosion 21
Hiroyoshi Mori, Sho Torii, and Renu Virmani
3.6 Biology of bypass vessels and their relation
to patency and disease 23
Thomas F. Lüscher
4. Anomalous coronary arteries 31
Chin Siang Ong, Ronald K. Binder, Marshall L. Jacobs,
and Duke E. Cameron
5. Non- invasive investigation of coronary
artery disease 39
5.1 Echocardiography and stress echocardiography for
coronary artery disease 39
Jae K. Oh
5.2 Nuclear cardiology 41
Aju P. Pazhenkottil and Ronny R. Buechel
5.3 Magnetic resonance imaging 45
Alexander Gotschy and Robert Manka
5.4 Cardiac computed tomography 48
Steve L. Liao
6. Ischaemia, hibernation, and viability 53
Roberto Ferrari
7. Invasive investigation of coronary artery
disease 57
7.1 Angiography 57
Matthew I. Tomey
7.2 Intravascular ultrasound 60
Lorenz Räber
7.3 Fractional flow reserve 63
Giovanni Ciccarelli, Emanuele Barbato, and
Bernard De Bruyne
7.4 Optical coherence tomography 67
Keyvan Karimi Galougahi, Tomasz Roleder,
Akiko Maehara, and Ziad A. Ali
SECTION 2
Treatment of coronary artery disease
Section editors:Patrick W. Serruys, David R. Holmes,
and Vasim Farooq
8. Heart Team management in coronary
revascularization:present reality and
future opportunities 73
Stuart J. Head, Michael J. Mack, David R. Holmes,
and David P. Taggart
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9. Evidence basis for decision- making between
coronary artery bypass grafting and
percutaneous coronary intervention:
present and future perspectives 79
Vasim Farooq, John D. Puskas, Patrick W. Serruys,
and David P. Taggart
10. Lifestyle management and secondary prevention
of coronary artery disease 97
Mansoor Ahmad, Sandra A. Weiss,
and William S. Weintraub
11. Optimal medical therapy for coronary
artery disease 103
David R. Holmes and Valentin Fuster
12. Differences and similarities between
American and European myocardial
revascularization guidelines 115
Milan Milojevic, Philippe Kolh, Stephen E. Fremes,
and Miguel Sousa- Uva
13. Comprehensive secondary cardiovascular
prevention and cardiac rehabilitation
SECTION 4
Pre- , intra- , and postoperative management of
the coronary artery bypass graft patient
Section editors:John M. Murkin and Gregory Fischer
18. Preoperative assessment in coronary
bypass surgery 155
Daniel Sellers and George Djaiani
19. Anaesthetic management of on- and off- pump
coronary artery bypass grafting 161
Elvera L. Baron, Menachem M. Weiner, and David L. Reich
20. Postoperative management after coronary artery
bypass graft surgery 167
Jason Chui and John M. Murkin
21. Fast- track cardiac anaesthesia and early
extubation 175
Janet Martin and Davy Cheng
22. Management of coagulopathy 181
Zev Noah Kornfield and George Despotis
after coronary artery bypass graft
surgery 121
Suegene K. Lee, Jay Khambhati, Pratik Sandesara,
Barry Franklin, and Laurence Sperling
SECTION 3
Danny Eapen, Gina Lundberg, Basil Margolis, Neil Gordon,
General outcomes of coronary artery
bypass graft surgery
Section editors:Stephen E. Fremes and Michael E. Halkos
14. Perioperative risk scoring systems for
coronary artery bypass grafting 131
T. Bruce Ferguson and Samer A.M. Nashef
15. Quality metrics in coronary artery
bypass grafting 135
Mario Gaudino, Vipin Zamvar, and Richard L. Prager
16. Early and late outcomes after coronary
artery bypass grafting 139
Stephen E. Fremes, Joseph F. Sabik, III, David P. Taggart,
Derrick Y. Tam, and Reena Karkhanis
17. Evidence base for off- pump coronary artery
bypass grafting:pros and cons 147
Emmanuel Moss, Michael E. Halkos, and John D. Puskas
SECTION 5
Management of cardiopulmonary bypass
Section editors:John M. Murkin and Gregory Fischer
23. Management of cardiopulmonary bypass 191
Robert A. Baker, David Fitzgerald, and Robert C. Groom
24. Minimal invasive extracorporeal circulation
for coronary revascularization surgery 205
Kyriakos Anastasiadis and Thierry Carrel
25. Cardioplegia strategies 211
Constantine L. Athanasuleas and Gerald D. Buckberg
26. Patient blood management strategies in cardiac
surgery 217
Aryeh Shander and Victor A. Ferraris
SECTION 6
Conduits for coronary artery bypass graft
surgery
Section editors:Tristan D. Yan, Ki- Bong Kim, Paul G. Bannon,
and Mario Gaudino
27. Early vein graft failure 227
Alexios S. Antonopoulos and Charalambos Antoniades
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28. The selection of conduits for coronary artery
bypass surgery 233
Mario Gaudino, Martin Misfeld, and R. John. L. Brereton
29. Storage solutions for vein grafts 237
Minh Quan Vu, Pierre- Emmanuel Noly, Walid Ben Ali,
and Louis P. Perrault
30. No- touch saphenous vein grafts in coronary
artery bypass surgery:a comprehensive
review 243
Ninos Samano and Domingos Souza
31. External stenting of vein grafts in coronary artery
bypass graft surgery 249
David P. Taggart
32. Revascularization using the saphenous vein
as a composite graft 255
Ki- Bong Kim
33. Personal perspectives on the early development
of internal thoracic artery grafting and the role of
bilateral internal thoracic artery grafting 259
George E. Green and Bruce W. Lytle
34. Bilateral internal thoracic arteries:
implications of the 10- year outcomes
of the Arterial Revascularisation Trial
(ART) 269
David P. Taggart
35. The radial artery 275
Robert F. Tranbaugh, Mario Gaudino, Brian F. Buxton,
and James Tatoulis
36. The right gastroepiploic artery graft 281
Hisayoshi Suma, Giuseppe Tavilla, and Ki- Bong Kim
37. Total arterial revascularization 285
Bobby Yanagawa, David P. Taggart, and John D. Puskas
38. Harvesting conduits:open versus
endoscopic 291
Alice Wang and Peter K. Smith
39. Harvesting arterial conduits:
skeletonized versus pedicle versus
semi- skeletonized 295
Umberto Benedetto, Brian F. Buxton, and David P. Taggart
40. Pharmacology to prevent spasm in
conduits 299
Guo- Wei He
SECTION 7
Technical aspects of coronary artery
bypass graft surgery
Section editors:Joseph F. Sabik, III, Stuart J. Head, and Vipin Zamvar
41. Optimal use of instruments for off- pump
coronary artery bypass grafting 309
Bobby Yanagawa, Michael E. Halkos, and John D. Puskas
42. Incisions for coronary revascularization 315
Valavunar A. Subramanian and Nirav C. Patel
43. Cannulation strategies of the aorta for coronary
surgery 319
Sajjad Raza, Khaled Shorbaji, Salil V. Deo,
and Joseph F. Sabik, III
44. How to perform a distal coronary
anastomosis 323
David Glineur and Juan B. Grau
45. Composite grafts 327
James Tatoulis and Brian F. Buxton
46. Sequential coronary grafting 333
Juan B. Grau, Jacqueline H. Fortier, and David Glineur
47. Off- pump coronary artery bypass grafting:tips
and tricks 337
Gianluca Torregrossa, David P. Taggart, and John D. Puskas
48. Intraoperative graft assessment with transit- time
flow measurement and epicardial ultrasound 343
Teresa M. Kieser and Gabriele Di Giammarco
49. Minimally invasive direct coronary artery
bypass 349
Volkmar Falk and Sebastian Holinski
50. Robotic coronary artery surgical
revascularization 353
Bob Kiaii, Vincenzo Giambruno, Michael W.A. Chu,
Mary Ann C. Wertan, and Francis P. Sutter
51. Hybrid coronary revascularization 359
Michael O. Kayatta, Henry A. Liberman, and Michael E. Halkos
52. Surgical techniques to bypass diffuse coronary
disease 363
Toshihiro Fukui and Shuichiro Takanashi
53. Redo coronary artery bypass grafting 369
Faisal G. Bakaeen and Lars G. Svensson
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5 4 . Avoiding stroke during coronary artery
bypass grafting
Gil Bolotin , Michael J. Mack , Antonino Di Franco ,
John D. Puskas, and Zvi Peled
375
5 5 . Anaortic coronary artery bypass grafting 381
W. Brent Keeling , Michael E. Halkos , and John D. Puskas
5 6 . Management and impact of preoperative,
intraoperative, and postoperative cardiogenic
shock/ cardiac arrest in coronary artery bypass
graft patients:the role of circulatory support
Roberto Lorusso , Hadi Toeg , Simon Maltais , Scott DeRoo ,
and Koji Takeda
5 7 . Prevention of mediastinitis 399
Harold L. Lazar
SECTION 8
Coronary artery bypass graft surgery
in special situations
Section editors: Naresh Trehan and Yasir Abu- Omar
385
6 3 . Coronary artery bypass grafting with surgical
ventricular reconstruction
Serenella Castelvecchio , Raffaella Molfetta , Andrea Garatti ,
and Lorenzo Menicanti
431
6 4 . Coronary anomalies:indications and technique,
including anomalous coronary arteries and
coronary artery fi stulas
Anita Nguyen , Ramachandra C. Reddy , and Hartzell V. Schaff
435
SECTION 9
Coronary artery bypass grafting
and other surgery
Section editors: Marc Ruel and David Glineur
6 5 . Coronary artery bypass grafting and mitral valve
surgery
Arman Kilic , Robert E. Michler , and Michael A. Acker
6 6 . Combined coronary artery bypass grafting and
aortic valve replacement
Christopher Lau and Leonard N. Girardi
443
451
5 8 . Coronary artery bypass grafting in
women
Jessica Yu Rove and Jennifer S. Lawton
405
59. Coronary artery bypass grafting in
octogenarians
Derrick Y. Tam , Reena Karkhanis , and Stephen E. Fremes
411
6 0 . Coronary artery bypass graft surgery in the
setting of acute myocardial infarction
Babatunde A. Yerokun and Peter K. Smith
415
6 1 . Coronary artery bypass grafting in patients with
ventricular dysfunction:indications, techniques,
and outcomes
Andrea Garatti , Serenella Castelvecchio , Alessandro Parolari ,
and Lorenzo Menicanti
419
6 2 . Coronary artery bypass grafting:diabetes and
kidney disease
Michael E. Farkouh and Valentin Fuster
423
6 7 . Coronary artery bypass grafting with the maze
procedure for atrial fi brillation
Hoda Javadikasgari and A. Marc Gillinov
455
6 8 . Coronary artery bypass grafting with
postinfarction ventricular septal defect and with
ventricular pseudoaneurysm
Mitesh V. Badiwala
461
6 9 . Coronary artery bypass grafting with concurrent
transmyocardial laser revascularization
Joshua L. Chan and Keith A. Horvath
469
7 0 . Prior percutaneous coronary intervention and
surgical revascularization
Suvitesh Luthra , Sunil K. Ohri , and David P. Taggart
475
7 1 . Guideline- directed medical therapy in coronary
artery bypass grafting
Ana- Catarina Pinho- Gomes and David P. Taggart
487
Index 493
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Contributors
Yasir Abu- Omar, MD, DPhil Department of
Cardiothoracic Transplantation, Royal Papworth
Hospital, Cambridge, UK
Michael A. Acker, MD Division of Cardiovascular
Surgery, Hospital of the University of Pennsylvania,
Philadelphia, PA, USA
Mansoor Ahmad, MD Christiana Care Health
System, Newark, DE, USA
Ziad A. Ali, MD, DPhil Center for Interventional
Vascular erapy, Division of Cardiology,
Presbyterian Hospital and Columbia University,
NewYork; Cardiovascular Research Foundation,
NewYork, NY, USA
Kyriakos Anastasiadis, MD, DSc, FETCS,
FCCP, FESC Cardiothoracic Department, AHEPA
University Hospital, Aristotle University of
essaloniki, essaloniki, Greece
Charalambos Antoniades, MD, PhD, FESC
Division of Cardiovascular Medicine, Radclie
Department of Medicine, University of Oxford,
Oxford, UK
Alexios S. Antonopoulos, MD, PhD Division of
Cardiovascular Medicine, Radclie Department of
Medicine, University of Oxford, Oxford, UK
Constantine L. Athanasuleas, MD Division of
Cardiothoracic Surgery, University of Alabama at
Birmingham, Birmingham, AL, USA
Mitesh V. Badiwala, MD, PhD, FRCSC Division of
Cardiovascular Surgery, Toronto General Hospital,
University Health Network, University of Toronto,
Toronto, ON, Canada
C. Noel Bairey Merz, MD, FACC, FAHA, FESC
Barbra Streisand Women’s Heart Center, CedarsSinai Smidt Heart Institute, Cedars- Sinai Medical
Center, Los Angeles, CA, USA
Faisal G. Bakaeen, MD Department of oracic
and Cardiovascular Surgery, Cleveland Clinic,
Cleveland, OH, USA
Robert A. Baker, PhD, CCP ( Aus) Perfusion and
Cardiothoracic Quality and Outcomes, Flinders
Medical Centre and Flinders University, Adelaide,
South Australia
Paul G. Bannon, MBBS, PhD, FRACS Sydney
Medical School, e University of Sydney, Sydney;
e Baird Institute of Applied Heart and Lung
Surgical Research, Sydney; Sydney Translational
Imaging Laboratory, Imaging and Phenotyping
Laboratory, Charles Perkins Centre, Faculty of
Medicine and Health, e University of Sydney,
Camperdown, Australia
Emanuele Barbato, MD, PhD Cardiovascular
Center Aalst, OLV Hospital, Aalst, Belgium;
Department of Advanced Biomedical Sciences,
University of Naples Federico II, Naples, Italy
Elvera L. Baron, MD, PhD Department of
Anesthesiology, Perioperative, and Pain Medicine,
Icahn School of Medicine at Mount Sinai
NewYork, NY, USA
Walid Ben Ali, MD Montreal Heart Institute,
Montreal, QC, Canada
Umberto Benedetto, MD, PhD, FHEA Bristol
Heart Institute, University of Bristol, Bristol, UK
Ronald K. Binder, MD University Heart Center,
Department of Cardiology, University Hospital
Zürich, Zürich, Switzerland
Eric Boersma, MSc, PhD Clinical Epidemiology
Research Unit, Erasmus MC, Rotterdam, e
Netherlands
Gil Bolotin, MD, PhD Department of Cardiac
Surgery, Rambam Health Care Campus,
Haifa, Israel
R. John. L. Brereton, FRACS Department of
Cardiothoracic Surgery, Royal North Shore
Hospital, Sydney, Australia
Nico Bruining, PhD, FESC Clinical and
Experimental Information Processing, Division of
Experimental Cardiology Erasmus MC, Rotterdam,
e Netherlands
Gerald D. Buckberg, MD, DSc Department of
Cardiothoracic Surgery, David Geen School of
Medicine at University of California, Los Angeles,
CA, USA
Ronny R. Buechel, MD Department of Nuclear
Medicine, Cardiac Imaging, University Hospital
Zurich, Zurich, Switzerland
Brian F. Buxton, MBBS, MS, FRACS Department
of Surgery, University of Melbourne, Melbourne,
Australia
Duke E. Cameron, MD Division of Cardiac
Surgery, Massachusetts General Hospital, Boston,
MA, USA
Thierry Carrel, MD Department of Cardiovascular
Surgery, University Hospital and University of
Bern, Bern, Switzerland
Serenella Castelvecchio, MD, FESC Department
of Cardiac Surgery, IRCCS Policlinico San Donato,
Milan, Italy
Joshua L. Chan, MD Department of
Cardiothoracic Surgery, Stanford University School
of Medicine, Stanford, CA, USA
Davy Cheng, MD, MSc, FRCPC,
FCAHS, CCPE Department of Anesthesia and
Perioperative Medicine; Critical Care Medicine,
Department of Medicine; Centre for Medical
Evidence, Decision Integrity & Clinical Impact
(MEDICI), Schulich School of Medicine
& Dentistry, Western University, London,
ON, Canada
Michael W.A. Chu, MD, FRCSC Division of
Cardiac Surgery, Department of Surgery, Lawson
Health Research Institute, Western University,
London, ON, Canada
Jason Chui, MBChB, FANZCA Department of
Anesthesia and Perioperative Medicine, Schulich
School of Medicine, University of Western Ontario,
London, ON, Canada
Giovanni Ciccarelli, MD University of Campania
‘Luigi Vanvitelli’, Monaldi Hospital, Naples, Italy
Bernard De Bruyne, MD, PhD Cardiovascular
Center Aalst, OLV Hospital, Aalst, Belgium;
Lausanne University Hospital, Lausanne,
Switzerland
Salil V. Deo, MD Department of Surgery,
University Hospitals Cleveland Medical Center,
Cleveland, OH
Scott DeRoo, MD Division of Cardiac Surgery,
University of Ottawa Heart Institute, Ottawa,
ON, Canada
George Despotis, MD Department of Pathology
and Immunology, Washington University School of
Medicine, St. Louis, MO, USA
Antonino Di Franco, MD Department of
Cardiothoracic Surgery, Weill Cornell Medical
College, NewYork City, NY, USA
Gabriele Di Giammarco, MD Department of
Cardiac Surgery, G.d’Annunzio University of
Chieti, Chieti, Italy
George Djaiani, MD, FRCA, FRCPC Department
of Anesthesia and Pain Management, Toronto
General Hospital, University of Toronto, Toronto,
ON, Canada
Dirk J. Duncker, MD, PhD Department of
Cardiology, oraxcenter, Erasmus MC,
Rotterdam, e Netherlands
Danny Eapen, MD Division of Cardiology,
Department of Medicine, Emory University School
of Medicine, Atlanta, GA, USA
Volkmar Falk, MD, PhD Department of
Cardiothoracic and Vascular Surgery, German
Heart Center Berlin; Department of Cardiovascular
Contributorsxviii
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Surgery, Charité- Universitätsmedizin Berlin,
Berlin, Germany; Department of Health Sciences,
Translational Cardiovascular Technologies, ETH
Zürich, Zürich, Switzerland
Michael E. Farkouh, MD, MSc Peter Munk
Cardiac Centre, Toronto General Hospital; Heart
and Stroke Richard Lewar Centre of Excellence in
Cardiovascular Research; Department of Medicine,
University of Toronto, Toronto, ON, Canada
Vasim Farooq, MBChB, MRCP, PhD University
Hospital Wales, Cardi, UK
T. Bruce Ferguson, MD Department of
Cardiovascular Sciences, East Carolina Heart
Institute, Greenville, NC, USA
Roberto Ferrari, MD, PhD Cardiovascular Centre,
Azienda Ospedaliero- Universitaria di Ferrara,
Ospedale di Cona, Ferrara; Maria Cecilia Hospital,
GVM Care & Research, E.S. Health Science
Foundation, Cotignola, Italy
Victor A. Ferraris, MD, PhD Department of
Surgery, University of Kentucky, Lexington,
KY, USA
Gregory Fischer, MD Department of
Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center,
NewYork, NY, USA
David Fitzgerald, DHA, MPH, CCP Division of
Cardiovascular Perfusion, Medical University of
South Carolina College of Health Professions,
Charleston, SC, USA
Jacqueline H. Fortier, MSc Division of Cardiac
Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Barry Franklin, PhD Department of
Cardiovascular Medicine, William Beaumont
Hospital, Royal Oak, MI, USA
Stephen E. Fremes, MD, MSc, FRCSC,
FACP, FACC Division of Cardiac Surgery,
Department of Surgery, Schulich Heart Centre,
Sunnybrook Health Sciences Centre, Toronto,
ON, Canada
Toshihiro Fukui, MD Department of
Cardiovascular Surgery, Kumamoto University
Hospital, Kumamoto; Department of
Cardiovascular Surgery, Sakakibara Heart Institute,
Tokyo, Japan
Valentin Fuster, MD, PhD Mount Sinai Heart,
NewYork, NY, USA; Centro Nacional de
Investigaciones Cardiovasculares Carlos III,
Madrid, Spain
Keyvan Karimi Galougahi, MD, PhD
Center for Interventional Vascular Therapy,
Division of Cardiology, Presbyterian Hospital
and Columbia University, NewYork, NY, USA
Andrea Garatti, MD Department of Cardiac
Surgery, IRCCS Policlinico San Donato, Milan, Italy
Mario Gaudino, MD Department of
Cardiothoracic Surgery, Weill Cornell Medicine,
NewYork, NY, USA
Vincenzo Giambruno, MD Division of Cardiac
Surgery, Department of Surgery, University of
Verona, Verona, Italy
A. Marc Gillinov, MD Department of oracic
and Cardiovascular Surgery, Heart and Vascular
Institute, Cleveland Clinic, Cleveland, OH, USA
Leonard N. Girardi, MD Department of
Cardiothoracic Surgery, Weill Cornell Medicine,
NewYork, NY, USA
David Glineur, MD, PhD Division of Cardiac
Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Neil Gordon, MD, PhD Intervent International,
Savannah, GA, USA
Alexander Gotschy, MD, MSc Department of
Cardiology, University Heart Center, University
Hospital Zurich; Institute for Biomedical
Engineering, University and ETH Zurich,
Zurich, Switzerland; Institute of Diagnostic and
Interventional Radiology, University Hospital
Zurich, Zurich, Switzerland
Juan B. Grau, MD Division of Cardiac Surgery,
University of Ottawa Heart Institute, Ottawa,
ON, Canada
George E. Green, MD St. Luke’s/ Roosevelt
Hospital, NewYork, NY, USA
Robert C. Groom, MS, CCP Tenwek Hospital,
Bomet, Kenya
Michael E. Halkos, MD, MSc, FACC, FACS Division
of Cardiothoracic Surgery, Department of Surgery,
Emory University School of Medicine, Atlanta,
GA, USA
Guo- Wei He, MD, PhD, DSc Department
of Cardiovascular Surgery and Center for
Basic Medical Research, TEDA International
Cardiovascular Hospital, Tianjin; Chinese Academy
of Medical Sciences and Peking Union Medical
College, Beijing; Zhejiang University and Hangzhou
Normal University, Hangzhou, China; Department
of Surgery, Oregon Health and Science University,
Portland, OR, USA
Stuart J. Head, MD, PhD Department of
Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, e Netherlands
Romana Herscovici, MD Leviev Heart Center,
Chaim Sheba Medical Center, Ramat Gan, Israel
Sebastian Holinski, MD, PhD Department
of Cardiovascular Surgery, CharitéUniversitätsmedizin Berlin, Berlin, Germany
David R. Holmes, MD Mayo Clinic, Rochester,
MN, USA
Keith A. Horvath, MD Association of American
Medical Colleges, Washington, DC, USA
Marshall L. Jacobs, MD Division of Cardiac
Surgery, Johns Hopkins Hospital, Baltimore,
MD, USA
Hoda Javadikasgari, MD Department of oracic
and Cardiovascular Surgery, Heart and Vascular
Institute, Cleveland Clinic, Cleveland, OH, USA
Reena Karkhanis, MD Division of Cardiac
Surgery, Department of Surgery, Schulich Heart
Centre, Sunnybrook Health Sciences Centre,
University of Toronto, ON, Canada
Michael O. Kayatta, MD BayCare Medical Group,
Clearwater, FL, USA
W. Brent Keeling, MD Division of Cardiothoracic
Surgery, Joseph B.Whitehead Department of
Surgery, Emory University School of Medicine,
Atlanta, GA, USA
Jay Khambhati, MD Department of Medicine,
Emory University School of Medicine, Atlanta,
GA, USA
Bob Kiaii, MD, FRCSC, FACS Department of
Surgery, UC Davis Health, Sacramento, CA, USA
Teresa M. Kieser, MD, PhD,
FRCSC, FACS Department of Cardiac Sciences,
Libin Cardiovascular Institute of Alberta,
University of Calgary, Calgary, AB, Canada
Arman Kilic, MD Division of Cardiac Surgery,
University of Pittsburgh Medical Center,
Pittsburgh, PA, USA
Ki- Bong Kim, MD, PhD Seoul National University
Hospital, Seoul, Korea
Philippe Kolh, MD, PhD Department of
Cardiovascular Surgery, University Hospital of
Liège, CHU Sart Tilman, Liège, Belgium
Zev Noah Kornfield, MD Hospital of the
University of Pennsylvania, Department of
Anesthesiology and Critical Care, Philadelphia,
PA, USA
Christopher Lau, MD Department of
Cardiothoracic Surgery, Weill Cornell Medicine,
NewYork, NY, USA
Jennifer S. Lawton, MD Division of Cardiac
Surgery, Johns Hopkins University, Baltimore,
MD, USA
Harold L. Lazar, MD Department of Cardiac
Surgery, Boston University School of Medicine,
Boston, MA, USA
Suegene K. Lee, MD Department of Medicine,
Emory University School of Medicine, Atlanta,
GA, USA
Amir Lerman, MD Department of Cardiovascular
Diseases, Mayo Clinic, Rochester, MN, USA
Steve L. Liao, MD Icahn School of Medicine at
Mount Sinai, NewYork, NY, USA
Henry A. Liberman, MD Division of Cardiology,
Emory University School of Medicine, Atlanta,
GA, USA
Roberto Lorusso, MD, PhD Department of
Cardio- oracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre
(MUMC), Cardiovascular Research Institute
Maastricht, Maastricht, e Netherlands
Gina Lundberg, MD Division of Cardiology,
Department of Medicine, Emory University School
of Medicine, Atlanta, GA, USA
Thomas F. Lüscher, MD, FESC, FACC University
Heart Center, Department of Cardiology,
University Hospital Zurich; Center for Molecular
Cardiology, University of Zurich, Zurich,
Switzerland
Suvitesh Luthra, MD Wessex Cardiothoracic
Centre, Southampton University Hospitals NHS
Trust, Southampton, UK
Contributors xix
https://t.me/medicina_free
Bruce W. Lytle , MD Department of Cardiac and
oracic Surgery, Baylor Scott & White, e Heart
Hospital, Plano, TX, USA
Michael J. Mack , MD Heart Hospital Baylor Plano,
Baylor HealthCare System, Dallas, TX, USA
Akiko Maehara , MD Center for Interventional
Vasc ul ar erapy, Division of Cardiology,
Presbyterian Hospital and Columbia University;
Cardiovascular Research Foundation, NewYork,
NY, USA
Simon Maltais , MD, PhD D e p a r t m e n t o f
Cardiothoracic Surgery, Mayo Clinic School of
Medicine, Rochester, MN, USA
Robert Manka , MD Department of Cardiology,
University Heart Center, University Hospital
Zurich; Institute for Biomedical Engineering,
University and ETH Zurich; Institute of Diagnostic
and Interventional Radiology, University Hospital
Zurich, Zurich, Switzerland
Basil Margolis , MD Division of Cardiology,
Department of Medicine, Emory University School
of Medicine, Atlanta, GA, USA
Janet Martin , PharmD, MSc (HTA&M) C e n t r e f o r
Medical Evidence, Decision Integrity & Clinical
Impact (MEDICI); Department of Anesthesia
and Perioperative Medicine and Department of
Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, Western University, London,
ON, Canada
Lorenzo Menicanti , MD Department of Cardiac
Surgery, IRCCS Policlinico San Donato, Milan, Italy
Robert E. Michler , MD Department of Surgery
and Department of Cardiothoracic and Vascular
Surgery, Monte ore Medical Center, Albert
Einstein College of Medicine, NewYork, NY, USA
Milan Milojevic , MD, PhD Departments of
Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia;
Department of Cardiothoracic Surgery,
Erasmus University Medical Center, Rotterdam,
e Netherlands
Martin Misfeld , MD, PhD University Department
of Cardiac Surgery, Leipzig Heart Center, Leipzig,
Germany
Raffaella Molfetta , MD Department of Cardiac
Surgery, IRCCS Policlinico San Donato, Milan, Italy
Hiroyoshi Mori , MD CVPath Institute,
Gaithersburg, MD, USA
Emmanuel Moss , MDCM, MSc McGill University,
Division of Cardiac Surgery, Jewish General
Hospital, Montreal, QC, Canada
John M. Murkin , MD, FRCPC, FACI D e p a r t m e n t
of Anesthesia and Perioperative Medicine, Schulich
School of Medicine, University of Western Ontario,
London, ON, Canada
Samer A.M. Nashef , MB ChB,
FRCS, PhD
Department of Cardiothoracic Surgery,
Papworth Hospital, Cambridge, UK
Anita Nguyen , MBBS D e p a r t m e n t o f
Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, USA
Pierre- Emmanuel Noly , MD M o n t r e a l H e a r t
Institute, Montreal, QC, Canada
Jae K. Oh , MD Integrated Cardiovascular Imaging,
Department of Cardiovascular Diseases, Mayo
Clinic, Rochester, MN, USA
Sunil K. Ohri , MD, FRCS Wessex Cardiothoracic
Centre, Southampton University Hospitals NHS
Trust, Southampton, UK
Chin Siang Ong , MBBS, PhD Division of Cardiac
Surgery, Massachusetts General Hospital, Boston,
MA, USA
Alessandro Parolari , MD, PhD D e p a r t m e n t o f
Cardiac Surgery, IRCCS Policlinico San Donato,
Milan, Italy
Nirav C. Patel , MD Department of Cardiovascular
and oracic Surgery, Lenox Hill Hospital,
Northwell Health, NewYork, NY, USA
Aju P. Pazhenkottil , MD Department of Nuclear
Medicine, Cardiac Imaging, University Hospital
Zurich, Zurich, Switzerland
Zvi Peled Division of Cardiac Surgery, University
of Toronto, Sunnybrook Health Sciences Centre,
Toronto, Ca na da
Louis P. Perrault , MD, PhD M o n t r e a l H e a r t
Institute, Montreal, QC, Canada
Ana- Catarina Pinho- Gomes , MD, MSc, MPH e
George Institute for Global Health, University of
Oxford, Oxford, UK
Richard L. Prager , MD Department of Cardiac
Surgery, University of Michigan, Ann Arbor,
MI, USA
John D. Puskas , MD Icahn School of Medicine
at Mount Sinai; Department of Cardiovascular
Surgery, Mount Sinai Morningside, Mount Sinai
Beth Israel and Mount Sinai West, New York, USA
Minh Quan Vu , MD Montreal Heart Institute,
Montreal, QC, Canada
Lorenz R ä ber , MD, PhD Catheterization
Laboratory, Department of Cardiology, Bern
University Hospital, Bern, Switzerland
Sajjad Raza , MD Department of Surgery,
University Hospitals Cleveland Medical Center,
Cleveland, OH, USA
Ramachandra C. Reddy , MD D e p a r t m e n t o f
Cardiovascular Surgery, Mount Sinai Medical
Center, NewYork, NY, USA
David L . Reich , MD D e p a r t m e n t o f
Anesthesiology, Perioperative, and Pain Medicine,
Icahn School of Medicine at Mount Sinai,
NewYork; e Mount Sinai Hospital, NewYork,
NY, USA
Tomasz Roleder , MD Department of Cardiology,
Medical University of Silesia, Katowice, Poland
Jessica Yu Rove , MD Department of Surgery,
Division of Cardiothoracic Surgery, University of
Colorado, Aurora, CO, USA
Marc Ruel , MD, MPH, FRCSC,
FAHA, FCCS
Division of Cardiac Surgery,
Department of Surgery, University of Ottawa,
Ottawa, ON, Canada
Joseph F. Sabik , III, MD Department of Surgery,
University Hospitals Cleveland Medical Center,
Case Western Reserve University School of
Medicine, Cleveland, OH, USA
Ninos Samano , MD, PhD D e p a r t m e n t o f
Cardiothoracic and Vascular Surgery and
University Health Care Research Centre, Faculty
of Medicine and Health, Ö rebro University,
Ö rebro, Sweden
Pratik Sandesara , MD Division of Cardiology,
Department of Medicine, Emory University School
of Medicine, Atlanta, GA, USA
Hartzell V. Schaff , MD D e p a r t m e n t o f
Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, USA
Daniel Sellers , BSc, MBBS,
FRCA, FRCPC
Department of Anesthesia and Pain
Management, Toronto General Hospital, University
of Toronto, Toronto, O N, C ana da
Patrick W. Serruys , MD, PhD D e p a r t m e n t o f
Interventional Cardiology, Erasmus University,
Rotterdam, e Netherlands; International Centre
for Circulatory Health, NHLI, Imperial College,
London, UK
Aryeh Shander , MD D e p a r t m e n t o f
Anesthesiology, Critical Care and Hyperbaric
Medicine, Englewood Hospital; Medical Center and
TeamHealth, Englewood, NJ, USA
Hiroaki Shimokawa , MD, PhD D e p a r t m e n t o f
Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
Khaled Shorbaji , MD Department of Surgery,
University Hospitals Cleveland Medical Center,
Cleveland, OH, USA
Peter K. Smith , MD Department of Surgery,
Division of Cardiovascular and oracic Surgery,
Duke University Medical Center, Durham,
NC, USA
Miguel Sousa- Uva , MD, PhD D e p a r t m e n t
of Cardiac Surgery, Hospital Santa Cruz,
Lisbon; Department of Surgery and Physiology,
Cardiovascular Research Centre, Faculty of
Medicine, Porto University, Porto, Portugal
Domingos Souza , MD, PhD D e p a r t m e n t o f
Cardiothoracic and Vascular Surgery, Faculty
of Medicine and Health, Ö rebro University,
Ö rebro, Sweden
Laurence Sperling , MD Division of Cardiology,
Department of Medicine, Emory University School
of Medicine, Atlanta, GA, USA
Valavunar A. Subramanian , MD Heart Repair
Technologies, Morgan Hill, CA, USA
Hisayoshi Suma , MD Suma Heart Clinic,
Tokyo, Japan
Francis P. Sutter , DO, FACS Lankenau Medical
Center, Wynnewood, PA, USA
Lars G. Svensson , MD, PhD Center for Coronary
Revascularization, Department of oracic and
Cardiovascular Surgery, Heart and Vascular
Institute, Cleveland Clinic, Cleveland, OH, USA
David P. Taggart , MD, PhD, FRCS N u eld
Department of Surgical Sciences, University of
Oxford, John Radcli e Hospital, Oxford, UK
Jun Takahashi , MD, PhD D e p a r t m e n t o f
Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
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