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Surgery pp 1621–1668Cite as

Adult Heart Disease

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Abstract

The surgical treatment of acquired cardiac diseases has become increasingly sophisticated in the past two decades—the expected mortality of most cardiac operations in adults has been reduced to extremely low levels—despite the fact that increasingly higher-risk patients are now candidates for surgery.1–3 In this regard, it is important to recognize that 75% of patients undergoing coronary bypass surgery in the Coronary Artery Surgery Study (CASS) in the late 1970s had an ejection fraction that was greater than 50%, and all patients were younger than 65 years of age, while in the Society of Thoracic Surgery (STS) database for coronary artery bypass in 2002, the average patient age was 67 years, and the average ejection fraction was 45%. Despite the reality of increasingly higher-risk patients undergoing coronary bypass surgery, the observed operative mortality for coronary bypass surgery in the 2002 STS database was 2.8%. Similarly, morbidity associated with coronary bypass surgery was found to have decreased from 1986 to 1994 in a series of nearly 8000 patients reported from the Cleveland Clinic, despite a significant rise in the patient risk profile in this series.3 Similar trends can be described for most facets of adult cardiac surgery.

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Authors and Affiliations

  1. Stony Brook University, Stony Brook, NY, USA

    Todd K. Rosengart MD (Chief, Cardiothoracic Surgery, Co-Director of the Heart Center at Stony Brook)

  2. Department of Surgery, Heart Center at Stony Brook, Stony Brook University, Stony Brook, NY, USA

    William de Bois MD (Fellow)

  3. Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA

    Edgar Chedrawy MD (Assistant Professor)

  4. Department of Medicine, Evanston Hospital, Evanston, IL, USA

    Malica Vukovic MD (Instructor)

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  1. Todd K. Rosengart MD
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Editors and Affiliations

  1. Department of Surgery, Stanford University Medical Center, Stanford, CA, USA

    Jeffrey A. Norton MD, FACS (Robert L. and Mary Ellenburg Professor, Chief) (Robert L. and Mary Ellenburg Professor, Chief)

  2. Divisions of Surgical Oncology and General Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA, USA

    Jeffrey A. Norton MD, FACS (Robert L. and Mary Ellenburg Professor, Chief) (Robert L. and Mary Ellenburg Professor, Chief)

  3. Departments of Surgery and Public Health, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA

    Philip S. Barie MD, MBA, FCCM, FACS (Professor, Chief) (Professor, Chief)

  4. Division of Critical Care and Trauma, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA

    Philip S. Barie MD, MBA, FCCM, FACS (Professor, Chief) (Professor, Chief)

  5. Departments of Surgery and Immunology, Duke University Medical Center, Durham, NC, USA

    R. Randal Bollinger MD, PhD, FACS (Professor) (Professor)

  6. Division of Surgical Oncology, Department of Surgery, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI, USA

    Alfred E. Chang MD, FACS (Chief, Hugh Cabot Professor of Surgery) (Chief, Hugh Cabot Professor of Surgery)

  7. Department of Surgery, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA

    Stephen F. Lowry MD, MBA, FACS (Professor and Chairman) (Professor and Chairman)

  8. Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Stephen F. Lowry MD, MBA, FACS (Professor and Chairman) (Professor and Chairman)

  9. Department of Surgery, The University of Utah, Salt Lake City, UT, USA

    Sean J. Mulvihill MD, FACS (Professor and Chair, Senior Director of Clinical Affairs) (Professor and Chair, Senior Director of Clinical Affairs)

  10. Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA

    Sean J. Mulvihill MD, FACS (Professor and Chair, Senior Director of Clinical Affairs) (Professor and Chair, Senior Director of Clinical Affairs)

  11. Departments of Cardiothoracic Surgery and Surgery, New York University Medical Center, New York, NY, USA

    Harvey I. Pass MD, FACS (Professor) (Professor)

  12. Radiology, and Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA

    Robert W. Thompson MD, FACS (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research) (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research)

  13. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Robert W. Thompson MD, FACS (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research) (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research)

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Rosengart, T.K., de Bois, W., Chedrawy, E., Vukovic, M. (2008). Adult Heart Disease. In: Norton, J.A., et al. Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68113-9_78

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