The Illustrated Handbook of Cardiac Surgery is adapted from the Second Edition of the color illustrated Manual of Cardiac Surgery (Springer-Verlag, 1995). The Illustrated Handbook of Cardiac Surgery communicates all the important informa­ tion, but eliminates the detailed explanation of judgment and technique that is relevant only to cardiac surgeons or other individuals intensely interested in these details. The chapters covering operations explain the basic concepts and fundamentals of the operations. A selection of the most important biblio­ graphic sources follows each chapter, but are not cited in the text. Individuals interested in more exhaustive coverage of information sources should consult the Second Edition of the Manual of Cardiac Surgery. The Illustrated Handbook of Cardiac Surgery should appeal to all individuals caring for cardiac surgical patients: cardiologists, anesthesiologists, radiolo­ gists, general surgery residents rotating on cardiac surgery, medical students, physician assistants, nurses, perfusionists, and all other members of the car­ diac surgery team. It should even appeal to laypeople who want to read about cardiac surgery in more depth than is available in lay publications. Our attempt has been to produce a book that is clearly written, clearly illustrated, and affordable. The techniques chosen are those developed over three decades of clinical practice and resident training at the Oregon Health Sciences University and St. Vincent Hospital, Portland, Oregon, and Sutter Memorial Hospital, Sacra­ mento, California. These techniques have served us well.

The Illustrated Handbook of Cardiac Surgery is adapted from the Second Edition of the color illustrated Manual of Cardiac Surgery (Springer-Verlag, 1995). The Illustrated Handbook of Cardiac Surgery communicates all the important informa­ tion, but eliminates the detailed explanation of judgment and technique that is relevant only to cardiac surgeons or other individuals intensely interested in these details. The chapters covering operations explain the basic concepts and fundamentals of the operations. A selection of the most important biblio­ graphic sources follows each chapter, but are not cited in the text. Individuals interested in more exhaustive coverage of information sources should consult the Second Edition of the Manual of Cardiac Surgery. The Illustrated Handbook of Cardiac Surgery should appeal to all individuals caring for cardiac surgical patients: cardiologists, anesthesiologists, radiolo­ gists, general surgery residents rotating on cardiac surgery, medical students, physician assistants, nurses, perfusionists, and all other members of the car­ diac surgery team. It should even appeal to laypeople who want to read about cardiac surgery in more depth than is available in lay publications. Our attempt has been to produce a book that is clearly written, clearly illustrated, and affordable. The techniques chosen are those developed over three decades of clinical practice and resident training at the Oregon Health Sciences University and St. Vincent Hospital, Portland, Oregon, and Sutter Memorial Hospital, Sacra­ mento, California. These techniques have served us well.

Originally published in 1980-1981 as a two-volume set, the Manual of Cardiac Surgery has been completely revised and now includes new full-color illustrations in a single convenient volume. This new edition maintains the high standards established in the first edition: insightful descriptions of various cardiac surgical procedures illuminated by clear, brilliant illustrations.

Over the past ten years, cardiac transplantation has evolved from an exper­ imental procedure performed in a handful of university centers to a viable therapeutic modality now performed in more than 150 centers worldwide. The complexity of the procedure, the changing immunosuppressive re­ gimes, and the follow-up care have necessitated a multidisciplinary ap­ proach involving a variety of medical, nursing, and social sciences special­ ties and subspecialties. In addition, health care trainees and referring physicians are increasingly becoming involved in the care of the cardiac transplant recipient. This book does not attempt to be a comprehensive treatise on cardiac transplantation; rather, we hope that it will serve as a manual and guideline for all health professionals involved in cardiac trans­ plantation. JEFFREY D. HOSENPUD, M.D. Contents Preface v Contributors IX 1. Cardiac Transplantation: An Overview JEFFREY D. HOSENPUD AND ALBERT STARR Immunogenetics and Immunologic Mechanisms of 2. Rejection 15 DOUGLAS J. NORMAN 3. Medical Therapy Tailored for Advanced Heart Failure 33 LYNNE WARNER STEVENSON 4. Ventricular Assistance as a Bridge to Cardiac Transplantation 53 D. GLENN PENNINGTON AND MARC T. SWARTZ Recipient Selection for Cardiac Transplantation 71 5. GEORGE A. PANTELY 6. Donor Selection and Management for Cardiac Transplantation 85 JEFFREY SWANSON AND ADNAN COBANOGLU 7. Operative Techniques and Early Postoperative Care in Cardiac Transplantation 95 ADNAN COBANOGLU Endomyocardial Biopsy: Techniques and Interpretation of 8.

Originally published in 1980-1981 as a two-volume set, the Manual of Cardiac Surgery has been completely revised and now includes new full-color illustrations in a single convenient volume. This new edition maintains the high standards established in the first edition: insightful descriptions of various cardiac surgical procedures illuminated by clear, brilliant illustrations.

The Illustrated Handbook of Cardiac Surgery is adapted from the Second Edition of the color illustrated Manual of Cardiac Surgery (Springer-Verlag, 1995). The Illustrated Handbook of Cardiac Surgery communicates all the important informa­ tion, but eliminates the detailed explanation of judgment and technique that is relevant only to cardiac surgeons or other individuals intensely interested in these details. The chapters covering operations explain the basic concepts and fundamentals of the operations. A selection of the most important biblio­ graphic sources follows each chapter, but are not cited in the text. Individuals interested in more exhaustive coverage of information sources should consult the Second Edition of the Manual of Cardiac Surgery. The Illustrated Handbook of Cardiac Surgery should appeal to all individuals caring for cardiac surgical patients: cardiologists, anesthesiologists, radiolo­ gists, general surgery residents rotating on cardiac surgery, medical students, physician assistants, nurses, perfusionists, and all other members of the car­ diac surgery team. It should even appeal to laypeople who want to read about cardiac surgery in more depth than is available in lay publications. Our attempt has been to produce a book that is clearly written, clearly illustrated, and affordable. The techniques chosen are those developed over three decades of clinical practice and resident training at the Oregon Health Sciences University and St. Vincent Hospital, Portland, Oregon, and Sutter Memorial Hospital, Sacra­ mento, California. These techniques have served us well.

The Illustrated Handbook of Cardiac Surgery is adapted from the Second Edition of the color illustrated Manual of Cardiac Surgery (Springer-Verlag, 1995). The Illustrated Handbook of Cardiac Surgery communicates all the important informa­ tion, but eliminates the detailed explanation of judgment and technique that is relevant only to cardiac surgeons or other individuals intensely interested in these details. The chapters covering operations explain the basic concepts and fundamentals of the operations. A selection of the most important biblio­ graphic sources follows each chapter, but are not cited in the text. Individuals interested in more exhaustive coverage of information sources should consult the Second Edition of the Manual of Cardiac Surgery. The Illustrated Handbook of Cardiac Surgery should appeal to all individuals caring for cardiac surgical patients: cardiologists, anesthesiologists, radiolo­ gists, general surgery residents rotating on cardiac surgery, medical students, physician assistants, nurses, perfusionists, and all other members of the car­ diac surgery team. It should even appeal to laypeople who want to read about cardiac surgery in more depth than is available in lay publications. Our attempt has been to produce a book that is clearly written, clearly illustrated, and affordable. The techniques chosen are those developed over three decades of clinical practice and resident training at the Oregon Health Sciences University and St. Vincent Hospital, Portland, Oregon, and Sutter Memorial Hospital, Sacra­ mento, California. These techniques have served us well.

Originally published in 1980-1981 as a two-volume set, the Manual of Cardiac Surgery has been completely revised and now includes new full-color illustrations in a single convenient volume. This new edition maintains the high standards established in the first edition: insightful descriptions of various cardiac surgical procedures illuminated by clear, brilliant illustrations.

Over the past ten years, cardiac transplantation has evolved from an exper­ imental procedure performed in a handful of university centers to a viable therapeutic modality now performed in more than 150 centers worldwide. The complexity of the procedure, the changing immunosuppressive re­ gimes, and the follow-up care have necessitated a multidisciplinary ap­ proach involving a variety of medical, nursing, and social sciences special­ ties and subspecialties. In addition, health care trainees and referring physicians are increasingly becoming involved in the care of the cardiac transplant recipient. This book does not attempt to be a comprehensive treatise on cardiac transplantation; rather, we hope that it will serve as a manual and guideline for all health professionals involved in cardiac trans­ plantation. JEFFREY D. HOSENPUD, M.D. Contents Preface v Contributors IX 1. Cardiac Transplantation: An Overview JEFFREY D. HOSENPUD AND ALBERT STARR Immunogenetics and Immunologic Mechanisms of 2. Rejection 15 DOUGLAS J. NORMAN 3. Medical Therapy Tailored for Advanced Heart Failure 33 LYNNE WARNER STEVENSON 4. Ventricular Assistance as a Bridge to Cardiac Transplantation 53 D. GLENN PENNINGTON AND MARC T. SWARTZ Recipient Selection for Cardiac Transplantation 71 5. GEORGE A. PANTELY 6. Donor Selection and Management for Cardiac Transplantation 85 JEFFREY SWANSON AND ADNAN COBANOGLU 7. Operative Techniques and Early Postoperative Care in Cardiac Transplantation 95 ADNAN COBANOGLU Endomyocardial Biopsy: Techniques and Interpretation of 8.

Originally published in 1980-1981 as a two-volume set, the Manual of Cardiac Surgery has been completely revised and now includes new full-color illustrations in a single convenient volume. This new edition maintains the high standards established in the first edition: insightful descriptions of various cardiac surgical procedures illuminated by clear, brilliant illustrations.