This book alternates its attention between the growing edge of cardiac surgery and established cardiac surgical practice. More than half is devoted to congenital heart disease. Recoarctation after infant coarct repair is shown to be preventable with the subclavian angioplastic technique. Novel solutions for more difficult problems are also suggested. For instance, when a distinct pulmonary artery is angiographically absent in patients with pulmonary atresia, meticulous surgical exploration of the lung hilum can result in the discovery of a vessel suitable for aortopulmonary shunting.
"Myocardial protection"—the current euphemism for minimizing operative myocardial injury—is well covered, as are complicated atrial septal defects, transposition, transplantation, and the merits of valvuloplasty vs valve replacement. Regarding the latter, one particularly deft chapter explains why the mere surgical imposition of a rigid mitral prothesis puts a considerable segment of ventricular muscle out of action.
Nuances, such as what really causes the abnormal superior ECG axis