Book Review: Minimally Invasive Cardiac Surgery: A Practical Guide

Minimally Invasive Cardiac Surgery: A Practical Guide
Theo Kofidis, Editor
CRC Press, Boca Raton, 2021
ISBN 1498736467, 496 pages, $200.00 (USD)

Cardiac surgeons do not read books with the same fervour as they did some thirty years ago; they simply do not need to. With the plethora of alternatives out there, including vibrant online material, fora, webinars, YouTube, and more, cardiac surgeons have the torment of choice. Moreover, the time of ten pounds of heavy books to prepare for an exit exam are over. Technology has brought about innovation and redefined the goals of surgical education and training. Audiovisual experience, rather than dry text, is the new norm in cardiac surgery training. This is particularly the case when it comes to a discipline as technical as minimally invasive cardiac surgery.

Theo Kofidis, a prominent cardiac surgeon and revered surgical teacher with many years of experience in minimally invasive heart surgery, has seen that change happen in real-time. Together with a luminous group of coauthors—true pioneers and leaders in their field—and a prolific yet historical publisher, he has produced something unique and innovative. Prominent surgeons like Hugo Vanermen, Johannes Bonatti, Marc Ruel, Vinod Thurani, and more flank this innovative effort with gravity and insight. Perhaps they have accomplished more than just a book, but rather a new educational concept that I am sure will find followers in other disciplines. The authors utilize the power of QR (quick response) codes embedded in the text to offer an unprecedented reading and learning experience in the world of surgery. This is the first book based not only on text, but also on QR codes. QR codes can be scanned during study of the book and instantly transfer the reader to relevant online material. This effectively turns the text-reading experience into a multimedia, audiovisual one. A brilliant idea indeed!

Undoubtedly, minimally invasive cardiac surgery (MICS) is the way to go. Cardiac surgery is going through its own cycle of evolution, just as abdominal and thoracic surgery did decades ago. A growing number of cardiac surgeons train in MICS surgery. It is a mode of professional survival, and it’s also in compliance with evolving patient demands. There is a huge and pressing trajectory around the globe toward less invasive techniques. The cardiologists and cardiac surgeons nowadays form heart teams to provide patients with novel, minimally invasive procedures. These teams aim for less trauma, higher safety, lower risk, faster recovery, and better cosmesis. 

Because of these changes, there is a great demand to learn and apply minimally invasive techniques. MICS belongs to every modern heart surgeon’s armamentarium. We need a book to accompany the surgeon along this path and provide true hints and solutions aside from the necessary basic knowledge. It should tell a surgeon which courses to visit, which videos to watch, and which centers to join for training. How can we exploit public and multimedia best? How can we set up a MICS program or practice? It should tell us how to do it, but also how not to do it. It is time for a dedicated MICS book by embedded surgeons who routinely do it and teach it—a true practical guide.

This book is new in content and modalities (QR-codes for internet referrals and visualization), and unique in its chapter layout. It is compatible with iPhones, Android phones, and iPads. It links to YouTube, learning libraries, and industry. Furthermore, it links to product webpages for ordering and understanding special tools, educational videos, recent online resources, and all existing exciting means.

This book is not just a textbook; it bridges the gap between reading about something and actually seeing a procedure and how it is done in a click or code scan. 

Chapter structure
This a practical guide. The chapters don’t dwell on anatomy and physiology of the target matter addressed. Instead, they go deep into surgical techniques, tools to be bought and utilized, places to go and learn, links to visual material, relevant controversies, and alternative approaches. This is the equipment the modern cardiac surgeon seeks, while expanding his skill and minimally invasive program.

Who is this book for?
Primary: Cardiac surgeons in training and subspecializing cardiac surgeons. Hybrid cardiologists and anaesthesiologists can equally benefit as they accompany minimally invasive procedures. Nurses and perfusionists will not want to miss its content, as they increasingly deal with evolving, less invasive strategies.

Secondary: All companies, sponsors, and departments involved in MICS surgery. They can distribute the book to all the workshop, booth, and event delegates. This book can also be used in MICS programs within hospitals. 

Contents
Chapter 1: Forward
Chapter 2: History of MICS
Chapter 3: How to Set Up a MICS Program (Team, Components, Training, Databases, Branding, Support)
Chapter 4: MICS OT Setup (Tools, Sutures, Lights and Cameras, Implants, Consumables)
Chapter 5: MICS Anaesthesia and Echocardiography in MICS: The Anaesthetists and Cardiologist’s Role in the MICS team
Chapter 6: Surgical Approaches in MICS (Positioning, Incisions and Exposure, Cannulation Techniques, Perfusion Techniques, etc)
Chapter 7.1: The Aortic Valve (Right Mini Thoracotomy)
Chapter 7.2: Upper J Sternotomy
Chapter 7.3: Sutureless Prostheses in the Setting of MICS 
Chapter 7.4: Endoscopic Aortic Valve Surgery
Chapter 8.1: TAVR Transapical
Chapter 8.2: Transfemoral AVR
Chapter 8.3: Alternative Transcatheter AVR Techniques
Chapter 9.1: Minimally Invasive Mitral Valve surgery
Chapter 9.2: Alternative Approaches to Minimally Invasive Mitral Valve Surgery
Chapter 9.3: Robotic Mitral Valve Surgery
Chapter 9.4: Percutaneous Mitral Valve Therapy: The Mitral Clip
Chapter 10: Minimally Invasive Tricuspid Valve Surgery
Chapter 11: Minimally Invasive Combined Heart Valve Surgery
Chapter 12.1: Minimally Invasive CABG
Chapter 12.2: Robotic CABG
Chapter 12.3: Anaortic CABG
Chapter 12.4: Hybrid CABG
Chapter 13: Minimally Invasive Atrial Ablation Surgery
Chapter 14.1: Minimally Invasive Ascending Aortic Surgery
Chapter 14.2: Hybrid Approaches for Minimally Invasive Arch and Descending Aortic Surgery
Chapter 15: Minimally Invasive Heart Failure Surgery
Chapter 16: Epilogue