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The fourth edition of Cardiac Surgery in the Adult is a collection of the most current knowledge and updated experiences of the world's leading cardiovascular experts treating adults with acquired, congenital, infectious, and traumatic diseases of the heart, including chapters from experts in the perioperative and postoperative management of patients.

Since the third edition, which was published in 2007, there have been many changes in the field of cardiovascular medicine. I believe this fourth edition will be a valuable tool to all in our specialty to help us understand the best treatment options available to our patients and how to master the skills to apply these therapies.

In addition, chapters on techniques long available to us for the treatment of all forms of adult acquired cardiac disease have been updated to re-emphasize the importance of the traditional approaches to heart disease. Video clip demonstrations of complex operative procedures, which we began in the third edition, continue in this edition and have increased in number.

I have dedicated this edition of Cardiac Surgery in the Adult to my surgical mentors. In this increasingly complex field of cardiovascular surgery I want to emphasize the importance of mentors in the training of surgical residents, fellows, and younger colleagues. In medical school Dr. Norman Shumway inspired me to be a heart surgeon and taught me how to become one. During my time at the National Heart Institute Dr. Andrew Glenn Morrow, along with his medical cohort Dr. Eugene Braunwald, taught me how to be an academic cardiothoracic surgeon. Dr. J. Englebert Dunphy from the University of California taught me a great deal when I first began my surgical training. And when I arrived at the Brigham and Women's Hospital in Boston I had the good fortune of working under Dr. Francis D. Moore, one of the all-time great academic surgeons. My friend and colleague, Dr. John J. Collins, Jr., gave me my first and only job as a cardiac surgeon, and we worked together for over 30 years to create one of the best cardiac surgery programs in the country. A more recent mentor is Dr. John A. Mannick, an outstanding leader and superb vascular surgeon. All of these men had a huge impact on my career. Without mentors we cannot learn the art and science of cardiovascular medicine to the highest level of excellence.

My thanks go to many individuals who have assisted in many ways to produce this volume. First and foremost, thanks to L. Henry “Hank” Edmunds, MD, for his initial inspiration for the first incarnation of Cardiac Surgery in the Adult and his trust in me to carry out his editorial expertise. Thank you to the editorial staff at McGraw-Hill, especially Mr. Brian Belval. A huge amount of gratitude goes to my executive assistant in the Division of Cardiac Surgery at the Brigham and Women's Hospital, Ann Maloney, who has been extremely helpful in the organization of the logistics and the publication minutia that is so important to a successful editorial process. A special thanks to Dr. Thomas Ferguson, a cardiac surgical pioneer and leader who has been president of both of the major American cardiothoracic surgical organizations, for writing an outstanding foreword to this edition.

Most importantly, we thank the chapter authors, who are some of the busiest physicians and surgeons in the world, for devoting their time and energy to produce superb chapters in every area in a timely fashion.

Finally, thanks to my family—Roberta, Leslie, Jennifer, Stephen, Carly, and Rachel—for their support, patience, and love through the production of Cardiac Surgery in the Adult, Fourth Edition.

Lawrence H. Cohn, MD
Boston, Massachusetts

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