The Operated Heart at Autopsy
The Operated Heart at Autopsy addresses the need of pathologists in practice and, especially, in training to achieve a new level of competence in dealing, at the time of autopsy, with the anatomic complexity of a heart that has undergone previous surgical
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The Operated Heart at Autopsy
The Operated Heart at Autopsy
Stuart L. Houser
The Operated Heart at Autopsy
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Stuart L. Houser Boston MA 02114 USA [email protected]
ISBN 978-1-60327-807-2 e-ISBN 978-1-60327-808-9 DOI 10.1007/978-1-60327-808-9 Springer Dordrecht Heidelberg London New York Library of Congress Control Number: 2009928015 © Humana Press, a part of Springer Science+Business Media, LLC 2009 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
After 17 years of private practice as a cardiovascular surgeon, my partners questioned the rationality of my decision to leave the clinical practice behind and become a cardiovascular pathologist. In fact, their disbelief of my intention to make the “leap of faith” was understandable. For a surgeon, the operating room is where the action is. It is as simple as that. And when a cardiac surgeon can hold in his hand a beating heart, now off-bypass and improved by an operation just completed, satisfaction is real and profound. However, life is complex. Throughout my surgical career, questions regarding the pathogenesis of atherosclerotic cardiovascular disease arose; curiosities of various phenotypes of the disease piqued my interest. I became aware of the power of investigative techniques that might address these questions. I then began to realize that my career in the operating room left me little time to address them. I needed to study the disease full time in order to contribute to my understanding of it. Ironically, my first autopsy as a pathology resident was on an individual with a past history of coronary artery bypass surgery. When it came to examining the heart, the dissection, as all pathologists know, was complex. However, I found it to be straightforward and enjoyable. But I subsequently learned that my fellow residents and mentors did not share my intrigue and comfort in defining the nuances of the operated heart. In fact, after my first autopsy in training, calls soon began coming from frustrated fellow residents who were facing, with significant wonder and trepidation, similar cardiac dissections at autopsy. To this day, twelve years later, the calls continue to come. My motivation to write this monograph came one evening when, as a first-year resident at
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