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Much has changed since first edition of the Johns Hopkins Manual of Cardiothoracic Surgery was published in 2007. First, the tried and true Halstedian-based paradigm of cardiothoracic surgical residency training as an 8- to 10-year apprenticeship has been challenged by new duty hour restrictions, intense scrutiny of clinical outcomes, and a seemingly endless parade of evidence-based quality measures and documentation requirements. Whether one deems these changes as progress or not, it is clear that they have affected the environment in which today's residents must learn the craft of cardiothoracic surgery, placing a premium on the time during which they can develop and reinforce their knowledge base from real-life clinical scenarios. Second, the advent of new integrated cardiothoracic surgical residency programs, taking trainees right out of medical school, have made integrated, practical, and concise references with content readily accessible to uninitiated medical graduates even more valuable. Finally, tremendous advances in new technologies, including catheter-based valve delivery systems, less-invasive surgical techniques, new mechanical circulatory devices, and hybrid approaches in the treatment of cardiothoracic disease have added to the already considerable knowledge base that cardiothoracic trainees must assimilate.

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We have been gratified that the first edition of the Johns Hopkins Manual of Cardiothoracic Surgery occupies a place among highly respected textbooks in our field and, in fact, serves as a sourcebook for the Thoracic Surgical Directors Association web-based curriculum. The second edition of this textbook, renamed the Johns Hopkins Textbook of Cardiothoracic Surgery, remains a comprehensive single-volume textbook covering topics in adult cardiac, congenital cardiac, and general thoracic surgery. It is intended as a core reference for all caregivers in the field of cardiothoracic surgery. We again formatted the book to facilitate review, prefacing most chapters with a “Key Concepts” section highlighting the epidemiology, pathophysiology, clinical features, diagnostic and treatment strategies, and outcomes for each topic. Additionally, based on our own critique of the first edition and thoughtful suggestions from its readers, we have made substantial improvements in the new edition, including colorized figures throughout the book, board-review questions and answers, and a greater emphasis on decision-making flow charts that are particularly useful in preparing for oral board examinations.

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The content of this textbook reflects the rapidly changing field of cardiothoracic surgery. In addition to the basic curriculum required for certification, we endeavored to include advanced concepts, controversial issues, and new technologies. For example, we have included completely reworked chapters covering Primary Lung Tumors, Mitral Valve Repair, and Mechanical Circulatory Support, as well as entirely new chapters covering Surgical Therapies for Atrial Fibrillation, Cardiac Surgery in Adults with Congenital Heart Disease, and Stem Cell Therapies for Cardiovascular Disease.

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As its title implies, most of the contributors to the Johns Hopkins Textbook of Cardiothoracic Surgery consist of current or past faculty, residents, fellows, and students at The Johns Hopkins Hospital. The fact that, in the course of our daily routines, we sometimes forget that many of our colleagues are nationally and internationally recognized experts in their respective fields owes to their humility and collegiality. Nevertheless, striving to produce the most authoritative textbook possible, we solicited many experts outside of the Hopkins community. We remain indebted to all of our contributors who generously donated their time and effort to make this a truly collaborative project.

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In addition to the contributing authors, we owe thanks to many other individuals. We greatly appreciate the patience and support of our editors and production staff at McGraw-Hill, in particular Christie Naglieri, Brian Belval, and Armen Ovsepyan, as well as the staff at Electronic Publishing Services. We are equally indebted to Kimberly Behrens in the Division of Cardiac Surgery at Hopkins, who took on the onerous and painstaking task of coordinating the many components of this book along with reminding contributors and, yes, Editors to keep on schedule. Also within the Division, Donna Riley, Diane Alejo, Lori Garrison, and Genie Sessa provided invaluable support and friendship. Finally, we wish to express our profound respect and admiration for our colleagues and staff on the cardiac and general thoracic surgical services at The Johns Hopkins Hospital who, in addition to being the very best in their professions, are among the most giving and thoughtful individuals that one could hope to work with.

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The sheer magnitude of work involved with assembling the first edition gave us pause in considering embarking on a second edition. We hope that you, like us, are glad that we did. Finally, we all would like to express our profound love and appreciation to our families who, rather than question our sanity, continued to support and encourage us in this undertaking.

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David D. Yuh, MD, FACC, FACS
Luca A. Vricella, MD, FACS
Stephen C. Yang, MD
John R. Doty, MD

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