Cardiac Surgery and the Cardiac Cath Lab

There has been a long history of collaboration at Mayo Clinic between cardiac surgery and the cardiac catheterization laboratory. Before the availability of cardiopulmonary bypass, cardiologists and cardiovascular surgeons investigated hemodynamics of congenital malformations managed surgically including coarctation of the aorta and patent ductus arteriosus. Cardiologists in the catheterization laboratory were critical to the development of open-heart surgery by providing detailed preoperative diagnostic studies. Less well understood are the important contributions of Dr. Earl Wood and his colleagues in the catheterization laboratory to intraoperative and postoperative care of cardiac surgical patients. Much of the development of physiologic monitoring used routinely in current practice can be traced to the innovations of these investigators. The rapid development of percutaneous approaches to many structural heart diseases coupled with the availability of modern noninvasive imaging has changed the relationship of surgeons with the catheterization laboratory, and this chapter gives one surgeon’s overview of this changing landscape.