Nearly a century has passed since Rehn performed the first successful cardiac operation by closing a right ventricular stab wound in a gravely ill patient. Moreover, it has been more than fifty years since Gross successfully corrected the first congenital cardiac malformation in 1938 by suture ligation of a patent ductus arteriosus. The introduction of the Blalock operation for tetralogy of Fallot by Blalock in 1944 greatly advanced the management and prognosis of a critically ill group of cardiac patients, and the success of this procedure further stimulated the development of concepts and techniques for the surgical management of other severe congenital cardiac defects. Until the successful use of extracorporeal circulation by Gibbon in 1953, it was often necessary to perform cardiac operations which were palliative rather than curative procedures. With the advent of additional new and improved techniques, correction of many hitherto incurable cardiac disorders became possible and reoperation under these circumstances became frequent. Cardiac surgery is very fortunate in having two master surgeons, whose distinctive contributions and clinical proficiency are recognized worldwide, to edit this extraordinary and unique text. They have placed emphasis on a number of specific complications of primary cardiac procedures which lead to the necessity for reoperation. Problems associated with postoperative infections, thrombotic dis orders, stenoses of suture lines, deterioration of prosthetic materials and mechanical valves, rejection of transplanted organs and tissues, and a host of additional complications are described together with their appropriate surgical management.
Auflage
Sprache
Verlagsort
Verlagsgruppe
Zielgruppe
Für Beruf und Forschung
Research
Illustrationen
388 s/w Abbildungen
388 figures
Maße
Höhe: 27 cm
Breite: 19.3 cm
Gewicht
ISBN-13
978-3-540-19552-8 (9783540195528)
DOI
10.1007/978-1-4471-1688-2
Schweitzer Klassifikation
Section I: General.- 1 Investigation Before Reoperations for Congenital Heart Disease.- Staged Procedures.- Residual Lesions.- Clinical Considerations.- Non-invasive Investigation.- Invasive Investigation.- Recurrent Lesions.- Changes Resulting from Growth, and Deterioration in Prosthetic Function.- Prognosis After Completion of Intended Management.- Conclusion.- 2 Investigations Before Reoperation for Acquired Heart Disease.- Methods of Investigation.- Non-invasive Investigation.- Invasive Investigation.- Reasons for Failure of Previous Operations.- Wrong Indication or Wrong Operation.- Valve Disease.- After Pericardiectomy.- Special Problems.- The Myocardium.- Marfan's Syndrome.- Myxoma and Other Cardiac Tumours.- Pregnancy.- Traumatic Heart Disease.- Emergencies.- Mechanical Disasters.- Prosthetic Valve Thrombosis "Encapsulation".- Infective Endocarditis.- Reoperation After Previous Coronary Bypass Surgery.- Pericardial Syndromes.- Postoperative Pericardial Collection.- Conclusion.- 3 Anaesthesia for Cardiac Reoperations.- Preoperative Assessment.- Anaesthesia.- Monitoring.- Specific Conditions.- Reoperation for Coronary Artery Bypass Grafts.- Valvar Heart Disease.- Congenital Heart Disease.- Postoperative Complications.- Conclusion.- 4 Approaches to the Heart and Great Vessels at Reoperation.- Sternal Re-entry.- Prevention.- Operative Technique.- Results.- Re-thoracotomy.- Conclusion.- 5 Reoperations in the Presence of Infection.- General Considerations.- Indications for Surgery.- Prosthetic Valve Endocarditis.- Infected Aortocoronary Bypass.- Infected Cardiac Suture Line.- Surgical Technique.- Reoperation in the Presence of Infected Prosthetic or Bioprosthetic Valves.- Surgical Technique for the Infected Cardiac Suture Line.- Surgical Treatment of Infected Coronary Bypass Graft.- Results.- Conclusions and Summary.- 6 Pacing: Indications, Technique of Insertion and Replacement of Leads and Generators.- Description of Generators.- Indications for Permanent Pacemaker Insertion.- Choice of Pacing Systems.- Generator.- Wire.- Pacing.- Temporary.- Permanent.- Generator Implantation.- Pectoral/Axillary Approach.- Subxiphoid Approach.- Suprarenal Approach.- Reoperation.- Pulse Generator Replacement.- Pacemaker Lead Problems.- Pacemaker System Replacement for Infection.- Follow-up.- Restrictions.- Conclusion.- 7 Postoperative Mediastinitis.- Aetiology.- Bacteriology.- History of Management Options.- Sternal Blood Supply.- Reconstructive Options.- Omentum.- Pectoralis Major.- Rectus Abdominis.- Complications.- Mediastinitis in Infants and Children.- Conclusions.- 8 Heart and Lung Retransplantation.- Cardiac Retransplantation.- Indications for Retransplantation.- Technique of Retransplantation.- Postoperative Care.- Results at Stanford University Hospital.- Summary.- Heart-Lung Retransplantation.- Indications for Retransplantation.- Technique of Retransplantation.- Postoperative Care.- Results.- Summary.- Section II: Congenital Heart Disease.- 9 Reoperations After Repair of Coarctation of the Aorta.- Problems Following Repair of Coarctation.- Residual/Recurrent Coarctation (Re-coarctation).- Aneurysm/Pseudoaneurysm.- Chylothorax.- Phrenic Nerve Palsy.- Vocal Cord Palsy.- Systemic Hypertension.- Operative Technique.- Re-coarctation.- Repair of Aneurysm/Pseudoaneurysm.- Results.- Residual/Recurrent Coarctation of the Aorta.- Aneurysm/Pseudoaneurysm.- 10 Reoperations for Interrupted Aortic Arch.- Problems.- Stenosis of the Aortic Anastomosis.- Subvalvar Stenosis.- Valvar Stenosis.- Supravalve Stenosis.- Residual VSD.- Previous Palliation.- Operative Techniques.- Techniques for First Operation.- Technique for Reoperation.- Postoperative Care.- Results.- Conclusion.- 11 Reoperations After Repair of Total Anomalous Pulmonary Venous Connection.- Problems.- Complications Requiring Medical Management.- Complications Requiring Surgical Management.- Surgical Technique.- Original Operation.- Reoperation.- Postoperative Management.- Results.- Early Results - Mortality After the Primary Operation.- Late Deaths Following the Primary Operation.- 12 Reoperations After Closure of Ventricular Septal Defects.- Problems.- Residual or Recurrent Intracardiac Shunt.- Arterial Valve Damage.- Atrioventricular Valve Dysfunction.- Outflow Tract Obstructions.- Haemolysis.- Postoperative Bacterial Endocarditis.- Conduction Disturbances.- Surgical Techniques.- Residual/Recurrent Intracardiac Shunts.- Additional VSDs.- Aortic Valve Regurgitation.- Atrioventricular Valve Dysfunction.- Outflow Tract Obstructions.- Haemolysis.- Endocarditis.- Pacemaker Insertion.- Postoperative Care.- 13 Reoperations After Repair of Tetralogy of Fallot.- Problems, Diagnosis and Indication for Reoperation.- Residual or Recurrent VSD.- Residual RVOTO.- Pulmonary Insufficiency.- Tricuspid Valve Insufficiency.- Right Ventricular Aneurysm.- Residual ASD.- Residual Surgical Shunt.- Surgical Technique.- Repair of Residual or Recurrent VSD.- Repair of RVOTO.- Repair of Pulmonary Insufficiency.- Repair of Tricuspid Valve Insufficiency.- Repair of Right Ventricular Aneurysm.- Repair of ASD.- Repair of Residual Surgical Shunt.- Postoperative Care.- Results.- 14 Reoperations After Mustard and Senning Operations.- Problems.- Mustard Operation.- Senning Operation.- Operative Technique.- Mustard.- Senning.- Results of Reoperations After Mustard or Senning Procedures.- 15 Reoperations After Arterial Switch Operation.- Complications.- Surgical Technique.- Original Operation.- Reoperation.- Results.- 16 Arterial Switch for Right Ventricular Failure Following Mustard or Senning Operations.- Problems.- Related to Previous Atrial Repair.- Related to the Concept of Atrial Repair.- Management and Surgical Technique.- Stage I. Pulmonary Artery Banding for RV Failure After Mustard/Senning.- Stage II. Conversion of Mustard/Senning to Arterial Switch.- 17 Aortic Valve Reoperations.- Secondary Aortic Valvotomy for Congenital Valvar Aortic Stenosis.- Problems.- Indication for Reoperation.- Surgical Technique.- Postoperative Care.- Results.- Secondary Aortic Valve Replacement.- Problems.- Indications for Reoperation.- Operative Technique.- Postoperative Care.- Results.- Enlargement of the Small Aortic Annulus.- Problems and Indications for Reoperation.- Operative Technique.- Results.- 18 Reoperations for Residual/Recurrent Left Ventricular Outflow Tract Obstruction.- Problems Following Initial Aortic Valvotomy.- Residual/Recurrent Aortic Stenosis.- Aortic Insufficiency.- Coronary Artery Insufficiency.- Supravalvar Aortic Stenosis.- Subvalvar Aortic Stenosis.- Problems Following Operative Repair of Subvalvar Aortic Stenosis.- Conduction Problem.- Aortic Valve Injury.- Mitral Valve Injury.- Ventricular Rupture.- Diagnosis and Evaluation.- Operative Technique.- Konno Aortoventriculoplasty.- Left Ventricle to Aorta Conduit.- Postoperative Management.- Results.- 19 Aortic Root Replacement.- Indications for Reoperation.- Left Ventricular Outflow Tract Obstruction.- Aortic Regurgitation.- Structural Defects.- Endocarditis.- Operative Technique of Aortic Root Replacement.- General Considerations.- Homograft Replacement of the Aortic Root.- Reoperation After Homograft Aortic Root Replacement.- Postoperative Management.- Results.- 20 Reoperations in Patients with Extracardiac Valved Conduits.- Problems.- Complications Related to Conduit Insertion.- Complications Unrelated to Conduit Insertion.- Operative Technique.- General.- Sternal Re-entry, Re-thoracotomy and Cannulation.- Conduit Replacement.- Replacement of Systemic (Tricuspid) Atrioventricular Valve in Patients with Congenitally Corrected Transposition.- Truncal Valve Incompetence.- Recurrent/Residual VSD.- Conduit or Ventricular Aneurysm/Pseudoaneurysm.- Recurrent/Residual Left Ventricular Outflow Tract Obstruction.- Residual/Recurrent Pulmonary Branch Stenoses.- Residual/Recurrent Major Aortopulmonary Collaterals.- Infection.- Postoperative Care.- Results.- 21 Reoperations After the Fontan Procedure.- Diagnosis of Problems and Indications for Reoperation.- Early Problems.- Late Problems.- Surgical Techniques/Treatment.- Early Problems.- Late Problems.- Postoperative Care.- Results.- 22 Reoperations for Atrioventricular Discordance.- Problems.- Recurrent or Increasing LVOTO.- Residual/Recurrent VSDs.- Systemic Atrioventricular Valve Regurgitation and Systemic Ventricular Failure.- Conduction Disturbances.- Surgical Considerations.- Anatomical Landmarks.- Surgical Techniques.- Postoperative Care.- Results.- Section III: Acquired Heart Disease.- 23 Reoperations for Coronary Artery Disease.- Incidence.- Indications for Reoperation.- Surgical Technique.- Results.- Conclusions.- 24 Reoperations on the Mitral and Tricuspid Valves.- Mitral Valve.- Problems.- Mitral Valve Conservative Surgery.- Causes and Incidence of Re-stenosis.- Causes and Incidence of Residual/Recurrent Regurgitation.- Diagnosis of Valve Malfunction and Timing of Reoperation.- Mitral Valve Replacement.- Surgical Technique.- Prosthesis-related Problems.- Patient-related Problems.- Operative Technique:Access to Mitral Valve.- Operative Technique: Surgery After Mitral Reconstruction.- Operative Technique: Valve Re-replacement.- Tricuspid Valve.- Problems.- Tricuspid Problems Overlooked During the Original Operation.- After Commissurotomy and Annuloplasty.- After Tricuspid Valve Replacement.- Operative Technique.- Access to Tricuspid Valve.- Reoperation on Triscuspid Valve.- Postoperative Care.- Results.- 25 Reoperations in the Surgical Treatment of Arrhythmias.- Reoperations for WPW.- Diagnosis and Indications.- Surgery.- Postoperative Care.- Results.- Reoperations for Direct Surgical Relief of Ventricular Tachycardia.- Diagnosis and Indications.- Surgery.- Postoperative Care.- Results.- Implantation of the Automatic Cardioverter/Defibrillator After Previous Sternotomy.- Diagnosis and Indications.- Surgery.- Postoperative Care.- Results.- 26 Reoperations for Thoracic and Thoracoabdominal Aneurysms.- Involvement of Multiple Aortic Segments.- Progression of Disease.- Problems.- Ascending Aorta and Aortic Arch.- Descending and Thoracoabdominal Aorta.- Diagnosis.- Operative Technique.- Perfusion Techniques and Hypothermia.- Current Reconstruction Techniques.- Results of Reoperation.- Ascending Aorta and Aortic Arch.- Descending and Thoracoabdominal Aorta.
