Authors: Siavosh Khonsari, MB; and Colleen Flint Sintek, MD
: Wolters Kluwer | Lippincott, Williams & Wilkins – 383 pages
Book Review by
: Hiro Motiram

This book is an extremely popular and highly-used book in the field of cardiac surgery.

On what basis am I making this statement?  I went on and clicked on “cardiac surgery” in the search field. I found more than 12,000 books on this subject! I could not believe my eyes! As I scrolled down the titles, this book by Drs. Khonsari, Sintek (and others) ranked a very high 12th.

What surprised me more is that the last – fourth – edition of this book was published a decade ago in 2007, whereas many popular books are more recent. But the first edition came out about thirty years ago, which means this book has endurance! Unless there is widespread use of a book as demonstrated by high sales numbers, newer editions are rarely published because it would not make economic sense.

As I began to browse through this book, it struck me immediately why this book has become such a long-term big seller. The clearly-written, easily-understandable, step-by-step instructions on each type of surgery with precise accompanying illustrations make it possible for even new trainees in surgery to learn the procedures by observation and practice.

This is a relatively shorter book on cardiac surgery than most others available on the market. It is meant to be neither comprehensive, covering every type of surgery involving the heart, nor detailed, wherein many other circumstances and scenarios are involved. But the types of cardiac surgeries this book covers are the following, which gives you a fairly good overview:

  • General Considerations
    • Surgical Approach to the Heart and Great Vessels
    • Preparation for Cardiopulmonary Bypass
    • Myocardial Preservation
    • Venting and De-airing the Heart
  • Surgery for Acquired Heart Disease
    • Surgery of the Aortic Valve
    • Surgery of the Mitral Valve
    • Surgery of the Tricuspid Valve
    • Surgery of the Aorta
    • Surgery for Coronary Disease
    • Surgery for Mechanical Complications of Myocardial Infarction
    • Heart Transplantation
    • Cardiac Tumors
    • Surgery for Atrial Fibrillation
  • Surgery for Congenital Heart Defects
    • Patent Ductus Arteriosus
    • Coarctation of the Aorta
    • Pulmonary Artery Banding
    • Vascular Ring and Pulmonary Artery Sling
    • Systemic Pulmonary Shunting
    • Atrial Septal Defect
    • Total Anomalous Venous Connection
    • Ventricular Septal Defect
    • Atrioventricular Septal Defect
    • Right Ventricular Outflow Tract Obstruction
    • Left Ventricular Outflow Tract Obstruction
    • Transposition of the Great Vessels
    • Aorto-pulmonary Window
    • Truncus Arteriosus
    • Ebstein Anomaly
    • Interrupted and Hypoplastic Aortic Arch
    • The Norwood Principle
    • The Fontan Principle
    • Coronary Artery Anomalies

Let us take a look at chapter 19, Atrial Septal Defect. This is a congenital (inborn) heart defect in which blood flows between the atria (upper chambers) of the heart. In a normal heart the atria are separated by a dividing wall called the interatrial septum.

If this wall or septum is defective (for example, it has a small or large hole) or absent, the patient has an atrial septal defect (ASD). In such a situation, oxygen-rich blood can flow directly from the left side of the heart to mix with the oxygen-poor blood in the right side of the heart, or vice versa, leading to lower-than-normal oxygen levels in the arterial blood that flows to the brain, organs and tissues. A low level of oxygen poses a threat to the life of the patient.

This chapter illustrates three types of ASD and the surgical repairs to fix them:

  • Ostium primum atrial septal defect
  • Ostium secondum atrial septal defect
  • Ostium venosus atrial septal defect

Step-by-step procedures are written in this (and all) chapters, along with fine line drawings to enable the reader to learn what to look for, what to do, and how to do them. And of course, practice after that, as many times as possible, as opportunities present themselves before you

This is an excellent, highly useful, and relatively compact guide to cardiac surgery: a must-have for all trainees in cardiac surgery, and a should have for established cardiac surgeons.



Siavosh Khonsari, MA, MB, BCh, FRCS(C), FACS, FACC is Clinical Professor of Surgery in the Division of Cardiothoracic Surgery at David Geffen School of Medicine at the University of California in Los Angeles, California.

Colleen Flint Sintek, MD is Clinical Associate Professor of Cardiothoracic Surgery at Keck School of Medicine at the University of Southern California in Los Angeles, California.


In collaboration with:

Abbas Ardehali, MD, FACS is Associate Professor of Surgery in the Division of Cardiac Surgery, and Director of Heart, Heart-Lung, and Lung Transplant Program at David Geffen School of Medicine at the University of California in Los Angeles, California.



Ramin E. Beygui, MD is Assistant Professor of Surgery in the Division of Cardiothoracic Surgery, and Director of Thoracic Aortic Aneurysm Service at David Geffen School of Medicine at the University of California in Los Angeles, California.

Kwok L. Yun, MD is Assistant Chief of the Regional department of Cardiac Surgery at Kaiser Permanente Medical Center in Los Angeles, California.



Timothy C. Hengst, CMI, FAMI