Technical aspects of modern coronary artery bypass

BOOK REVIEW: Technical Aspects of Modern Coronary Artery BypassRobert F Tranbaugh, MDDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NYData Availability: NAFunding: NoneConflict of Interest: NoneInternational Review Board: NAInformed Consent: NACorresponding author:Robert F Tranbaugh, MDDepartment of Cardiothoracic SurgeryWeill Cornell Medicine505 East 68th StreetNew York, NY 10065Rft9008@med.cornell.eduWord Count: 484After recently purging most of my reference textbooks (many from the 1970’s and 1980’s and including the big names from the “Golden Age” of cardiac surgery—Glenn, Sabiston and Kirklin), I wondered if the era of the well-recognized, authoritative textbook was over. I actually cannot remember the last textbook I purchased. While a resident at UCSF, textbooks were critically important as the library closed at midnight. I grew up with the “red book”, Dunphy and Way’s “currentSurgical Diagnosis and Treatment”. This paperback nicely covered the basics of surgery and, importantly, was readily available for residents well before Google. Primarily for sentimental reasons, I kept my 1983 edition.So, why a surgical textbook in 2021? What is the appeal, attraction and need?Gaudino’s “Technical Aspects of Modern Coronary Artery Bypass Grafting” has enormous appeal. For one, it is beautifully illustrated with very useful drawings along with attractive and detailed operative photos. At times, I felt like I was visiting the author-surgeon in his or her operating room. The world’s leading experts have provided detailed step by step technical instructions, which are clear, concise and very helpful. For cardiac surgeons considering starting a multiple arterial grafting (MAG) program, this textbook is a needed and wonderful resource.The attractions of Gaudino’s testbook are many. First, “Technical Aspects” clearly reflects Gaudino’s stellar and highly productive career as an investigator and practitioner of MAG. He has systematically addressed the details of MAG. Conduit selection, harvest and utilization are all outlined in exquisite step by step detail. Complex grafting techniques are reviewed and beautifully illustrated. I especially enjoyed Chapter 12 by Rocha and his colleagues on their nicely done essay on the proximal anastomosis, or what I consider to be “the forgotten anastomosis”. The authors review the many important technical details and critical issues impacting the patency of a bypass graft.All of the chapters are well written, beautifully illustrated, highly practical and very helpful for residents in training, for early career surgeons and for well-established cardiac surgeons interested in coronary artery bypass. Gaudino should also be commended for the addition of Chapter 23 by Fremes and Tatoulis on the management of perioperative ischemia and Chapter 24 by Lazar on optimizing medical therapy. These are incredibly important chapters on “non-technical” yet critical issues with excellent recommendations.Gaudino’s “Technical Aspects” is a clearly needed and a highly authoritative textbook which will serve as an excellent roadmap for surgeons interested in starting a MAG program. It hopefully will allow surgeons to move from the “house special” CABG (one internal mammary and veins) mentioned by Girardi in his thoughtful Foreward to more arterial grafting performed with greater confidence and commitment. “Technical Aspects” will also serve as an important resource for surgeons at all levels of training and expertise. I currently have lots of room on my near empty book shelf. “Technical Aspects” will be on my book shelf and belongs on yours!