When Cardiac Surgery Goes Wrong

This collection of 61 clinical vignettes represents more than case studies in cardiac surgery; It will also serve cardiac anesthesiologists, perfusionists, surgical nurses and other members of the cardiac surgical team who play crucial roles in patient care. This collection of 61 clinical vignettes represents more than case studies in cardiac surgery; it embodies a philosophy of learning a lifetime of cardiac surgical practice and embraces our fallibility as a pathway to excellence. Each scenario has been carefully written to illuminate the complex decision-making processes, technical challenges and human factors that define outcomes. More importantly, each case demonstrates how errors—whether technical, cognitive or systemic—can become powerful catalysts for improvement when approached with intellectual honesty and systematic analysis. These cases draw upon decades of collective surgical experience, peer-reviewed literature and quality improvement data to ensure that each one offers meaningful learning opportunities. Within each case, the anatomy of the error has been dissected for a better understanding of the mechanism and its downstream impact, and lessons from the case are discussed and followed by a succinct scientific and evidence-based discussion for further clarification. This book is intended for cardiac surgeons at all stages of their careers, from residents beginning their journey in this demanding specialty to experienced practitioners seeking to refine their practice. It will also serve cardiac anesthesiologists, perfusionists, surgical nurses and other members of the cardiac surgical team who play crucial roles in patient care.