Abstract
The tortuous way cardiac surgery continues to evolve and the way its advance depends upon positive feedback from basic science is well illustrated in this potpourri of review articles. The essay on conduits in the pulmonary circulation, for example, laments the neointimal ingrowth, thrombus formation, and valve deterioration that imbrue this operation and make it one of the “ongoing weak links in reconstructive congenital heart surgery.” Molecular biological explanations for these commonly-observed problems are then given in two remarkably readable chapters on coagulation and intimal hyperplasia. How to inhibit or modulate vascular smooth-muscle cell proliferation in vein grafts (eg, with antisense oligonucleotides or by viral transfer of either genes or vascular cell adhesion molecules) is particularly well detailed.
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