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SurgSpace / Specialties / Cardiac Surgery

Cardiac Surgery

The heart and great vessels: bypass grafting built on the coronary map, valve repair and replacement stitched millimetres from the conduction system, and the physiology of cardiopulmonary bypass, the machine that lends the patient a heart and lungs for an hour.

3 operations in depth5 interactive cases

Backdrop: A cardiac surgery operating room · Pfree2014 · CC BY-SA 4.0

The library

Media

Every curated image, scan and video for this specialty, filterable.

Every curated image, scan and video for this specialty, each with its source one tap away. Nothing here is decoration.

Angiography
Coronary angiogram of the left coronary system, the arteries drawn in dark contrast against a grey field, with a tight narrowing in the proximal left anterior descending artery
Coronary angiography · a preocclusive stenosis in the proximal LAD after thrombus aspiration
Operative photo
Operating room during cardiac surgery with the cardiopulmonary bypass machine, its reservoir and tubing in the foreground and the surgical team at the table behind
Inside the OR · the bypass circuit connected to the patient during a cardiac operation
Operative photo
A perfusionist in scrubs adjusting the heart-lung machine, with the oxygenator, reservoir and pump console in view
Inside the OR · a perfusionist operating the heart-lung machine
Operative photo
Operative photograph through a sternotomy: gloved hands hold fine forceps and a swab over the surface of the heart while a bypass line runs across the lower field
Operative photograph · coronary artery bypass grafting on cardiopulmonary bypass, the grafts being sewn on the surface of the heart
Clinical photo
Photograph of an adult chest from below the neck to the navel showing a healing vertical midline sternotomy incision and three small drain-site sutures below it
Post-operative · a median sternotomy incision and the drain sites beneath it, healing
Ultrasound
Photograph of an echocardiography monitor showing a continuous-wave Doppler trace with a small colour Doppler image of the heart above it
Echocardiography · continuous-wave Doppler of mitral regurgitation, photographed from the monitor
Ultrasound
Continuous-wave Doppler trace through the aortic valve from a transthoracic echocardiogram, with the measured peak velocity and gradients listed beside a small two-dimensional image
Echocardiography · continuous-wave Doppler through a stenotic aortic valve, from a CardioNetworks ECHOpedia case
Educational illustration
Anterior view of the heart with the coronary arteries drawn and labelled
Coronary anatomy · anterior view with the left main, LAD, circumflex and right coronary arteries
Educational illustration
Diagram of the heart and its coronary arteries as seen from the left anterior oblique angle
Angiographic projection · left anterior oblique view of the heart and coronaries
Educational illustration
Diagram of the heart and its coronary arteries as seen from the right anterior oblique angle
Angiographic projection · right anterior oblique view of the heart and coronaries
Educational illustration
Gray's Anatomy plate of the anterior chest wall showing the internal mammary artery and its branches
Conduit anatomy · the internal mammary (thoracic) artery and its branches, Gray's Anatomy plate 522
Educational illustration
Medical illustration of a heart after triple coronary artery bypass grafting, showing the grafted vessels
CABG · a triple bypass illustrated: grafts routed around the diseased segments to the vessels beyond them
Educational illustration
Medical illustration of one typical way a heart-lung machine is connected to the veins and arteries near the heart
Cardiopulmonary bypass · one typical way the circuit is connected to the great vessels
Educational illustration
Three-panel medical illustration: the catheter route from the groin to the heart, the coronary arteries on the heart, and the angiographic view with a narrowing circled
Coronary angiography, illustrated · catheter route, coronary tree, and the angiographic view of a stenosis
Educational illustrationSynthetic educational image
Synthetic educational image · schematic coronary tree for interpretation practice
Educational illustration
Schematic drawing of the aorta from the arch to the iliac bifurcation with the dissection shaded along the ascending and descending segments, labelled DeBakey I and Stanford A
Aortic dissection, illustrated · a DeBakey type I (Stanford A) dissection involving ascending and descending aorta
Educational illustrationSynthetic educational image
Synthetic educational image · schematic axial CTA for flap-finding practice
Pathology
Gross pathology photograph of an excised heavily calcified aortic valve
Gross pathology · rheumatic aortic stenosis, the valve the surgeon excises
Operative photo
A cardiac surgery operating room with the team, perfusion equipment and monitors in view
Inside the cardiac OR · surgeon, perfusion console and the bypass circuit
CT angiography
Curved planar reformat from a CT angiogram following a single coronary artery, with an arrow and an arrowhead marking bright plaque along its wall
Coronary CT angiography · a single vessel straightened along its course, with calcified plaque marked

Videos

Curated and attributed

  • Cardiopulmonary bypass: the role of the circuit

    Why the operation needs a machine at all: a still, bloodless heart with the body still perfused.

    Watch for

    • What bypass takes over, and what it does not
    • Why the heart can be stopped safely once the circuit runs
    • Who in the room owns the machine
    Source: CTSNet · Watch on YouTube

  • Cardiopulmonary bypass: the circuit

    The path blood takes from the venous cannula through the reservoir, oxygenator and pump back into the aorta.

    Watch for

    • Venous drainage into the reservoir
    • The oxygenator and where gas exchange happens
    • The arterial line and the cannula it returns to
    Source: CTSNet · Watch on YouTube

  • Cardiopulmonary bypass: circuit components

    Each part of the circuit named and explained: cannulae, reservoir, pump heads, oxygenator, filters and suckers.

    Watch for

    • Roller versus centrifugal pump
    • Where the cardiotomy suckers return blood
    • What the arterial filter is protecting
    Source: CTSNet · Watch on YouTube

  • Cardiopulmonary bypass: pathophysiology

    What non-pulsatile flow, haemodilution, hypothermia and the foreign circuit do to the body, and why the ICU course follows.

    Watch for

    • The inflammatory response to the circuit
    • Haemodilution and why haematocrit falls
    • Why kidneys and brain are the organs the team watches
    Source: CTSNet · Watch on YouTube

  • Cardiopulmonary bypass: conduct and weaning

    Going on, running the pump, and the choreography of coming off: rewarming, rhythm, filling and the cannulae out.

    Watch for

    • The checklist before going on bypass
    • What the perfusionist reports and how often
    • Weaning: heart filled, rhythm restored, flow handed back
    Source: CTSNet · Watch on YouTube

  • Cardiopulmonary bypass: emergency scenarios

    What goes wrong on the pump and what the team does in the first minute: air, dissection at the cannula, pump failure, oxygenator failure.

    Watch for

    • Massive air embolism and the immediate response
    • Aortic dissection at cannulation
    • Oxygenator or pump failure and the backup plan
    Source: CTSNet · Watch on YouTube

  • Coronary artery bypass surgery

    Sternotomy, conduit, bypass and the grafts, in the words of the centre that does the most of them.

    Watch for

    • Where the internal mammary artery goes and why
    • Vein grafts from the leg
    • Coming off bypass
    Source: Cleveland Clinic · Watch on YouTube

  • Aortic valve surgery

    Replacing the aortic valve: the aortotomy, excising the leaflets and seating the prosthesis.

    Watch for

    • Cardioplegia and the still heart
    • Decalcifying the annulus without perforating it
    • Mechanical versus tissue valve
    Source: Cleveland Clinic · Watch on YouTube

  • Demystifying mitral valve repair

    Why repair beats replacement for degenerative disease, and what the surgeon does to the leaflet.

    Watch for

    • The prolapsing segment
    • Resection or neochords
    • The annuloplasty ring
    Source: Cleveland Clinic · Watch on YouTube

  • Creating the chordae system for anterior leaflet mitral repair

    Operative footage of artificial chordae for the anterior leaflet.

    Source: CTSNet · Watch on YouTube

Hub shaped by the Surgical Specialties Lead with the Cardiac surgery reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.