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The second edition of Cardiac Surgery in the Adult builds on the great success of the first edition, edited by Dr. L. Henry Edmunds. The first edition became the gold standard for adult cardiac surgical textbooks, departing from traditional multi-subspecialty thoracic textbooks involving pediatric, general thoracic, and adult cardiac surgery. Dr. Edmunds’ edition blazed a trail by focusing on the information about adult cardiac surgery and provided a tremendous leap forward in our knowledge base.

In the second edition, we have added 19 new chapters in areas related to new technology, and subdivided previous chapters because of the expanded information that is now available in many areas. For example, there are entirely new chapters on minimally invasive valve surgery, coronary angiogenesis, and endovascular stent management of thoracic aortic disease. We have added a new chapter on intraoperative echocardiography for surgeons. The chapter on extracorporeal circulation now contains four major subchapters in order to organize and clearly present the enormous expansion of knowledge about artificial circulation. Other chapters from the first edition have been divided into several new chapters because of the increase in knowledge, particularly in the area of aortic valve surgery. There are now chapters on aortic valve repair and valve-sparing operations, stented bioprosthetic valves, stentless valves (including autograft, homograft, and porcine valves), as well as separate chapters on surgery for endocarditis of the aortic and mitral valves. Because of the continuing evolution of cardiac arrhythmia surgery, we have added a chapter on cardiologic intervention therapy as well as a separate chapter on surgery for ventricular and atrial arrhythmias. Two new chapters involving nontransplant surgical options for heart failure, an increasingly complex field, are also included, as well as one on tissue engineering. What the cardiac surgeon does in the 21st century has changed; perhaps there will be a lesser emphasis on coronary surgery because of interventional techniques, but the cardiac surgeon still has an extremely full and complex array of operations to understand and use on an aging patient population with increasingly complex disease states. We believe that the information in this volume will help to address virtually all the new areas of cardiac surgery that will be employed in the 21st century.

In assuming the editorship of this book, I felt it was important to publish this information as quickly as possible to maximize the effect of the new technology. Thus, the call for chapters was sent out in November 2001 and all chapters were received by the end of September 2002, allowing for publication in early 2003, to commemorate the 50th anniversary of the first successful open heart operation using cardiopulmonary bypass. Textbooks are relevant only to the degree that the information in them is current, and we believe that to be a central part of our mission.

I am indebted to several people for the production of this volume. First and foremost, L. Henry “Hank” Edmunds, M.D., asked me to carry on the legacy of this very important book, and for this I am very grateful. His help has been incredibly important, and his experience, invaluable. His editorial duties with the Annals of Thoracic Surgery have made him a superb editor, and he has been of tremendous help to me. I am indebted to Marc Strauss, my editor at McGraw-Hill, who has been extremely supportive and helpful in every way in getting this book organized and completed. I am also very grateful to Ann Maloney, my administrative assistant in the Division of Cardiac Surgery at the Brigham, who was extremely helpful in pointing out ways to improve efficiency and helping to politely cajole chapter authors to get their chapters in on time. Also, Kitty McCullough at McGraw-Hill and Susan Hunter at Andover Publishing Services helped with the technical construction of this book and deserve tremendous credit.

But in the final analysis the most deserving thanks must go to all of the chapter authors, who are among the busiest cardiac surgeons on Earth. They took the time and energy to produce superb analysis of their particular areas of expertise on schedule.

I would like to thank Norman Shumway, who was not only my cardiac surgical mentor but who has also been a great supporter of mine throughout my career and who has written a pithy Foreword for this book.

Finally, to my family, who have supported me during the increased amount of time that this project has taken, I give my love and thanks.

Lawrence H. Cohn, M.D.
Boston, Massachusetts

Copyright 2003, 1997 by the McGraw-Hill Companies, Inc.
All rights reserved. Printed in the United States of America.
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