Preface

Chapter 27 **Current Challenges in the Treatment of Deep Sternal Wound Infection Following Cardiac Surgery 493**

Vladimír Lonský

**VIII** Contents

Martin Šimek, Martin Molitor, Martin Kaláb, Patrick Tobbia and

The latest diagnostic and therapeutic modalities in the management of coronary artery dis‐ ease by coronary artery bypass graft surgery and by percutaneous coronary intervention with stenting and in the interventional management of other atherosclerotic vascular disease have led to a reduction in cardiovascular mortality and morbidity. This book entitled Artery Bypass provides an excellent update on these advances which every physician seeing pa‐ tients with atherosclerotic vascular disease should be familiar with. This book includes 27 chapters written by experts in their topics.

The first section of this book discusses basic science and physiology and includes 6 chapters. The second section of this book discusses coronary artery bypass graft surgery and includes 11 chapters. The third section of this book discusses percutaneous coronary intervention with stenting and includes 3 chapters. The fourth section of this book discusses peripheral and cerebral vascular disease intervention and includes 5 chapters. The fifth section of this book discusses miscellaneous cardiac surgical topics and includes 2 chapters. Another strength of thisbook is that unresolved issues are also discussed.

I would like to thank all of the contributors for their outstanding work. Finally, I would like to thank you, the reader, for your commitment to providing the best possible care to your patients with atherosclerotic vascular disease. I hope you will find this book a valuable re‐ source in providing excellent care to your patients with atherosclerotic vascular disease.

> **Wilbert S. Aronow, MD, FACC, FAHA, FCCP, FACP** Professor of Medicine, New York Medical College Valhalla, NY, USA

**Section 1**

**Basic Science and Physiology**

**Basic Science and Physiology**

**Chapter 1**

**Impact of Ischemia on Cellular Metabolism**

(1) cellular acidosis;

(3) cellular swelling;

the energy substrates;

molecules;

**Table 1.** Major cellular consequences of ischemia

(4) cytoskeleton disorganization;

As in all aerobic eukaryotic cells, oxygen is essential for homeostasis in human cells. The in‐ terruption of blood flow to tissues results in an arrested oxygen supply and disrupts the bio‐ chemical reactions that ensure the smooth functioning, integrity and survival of the cells. The limited oxygen reserves that are dissolved in the interstitial fluid and are bound to he‐ moglobin, myoglobin and neuroglobin do not maintain efficient, long-term metabolism.[1,2] Lack of oxygen affects all functions within the cell. Table 1 summarizes the main cellular

(2) loss of sarcoplasmic membrane potential;

(5) reduction of adenosine-5'-triphospate (ATP) and phosphocreatine is more than reduction in

(6) reduction of glutathione, of a-tocopherol; (7) increasing expression of leukocyte adhesion

and reproduction in any medium, provided the original work is properly cited.

© 2013 Gourdin and Dubois; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

(8) secretion of cytokines/chemokines - Tumor Necrosis Factor (TNF-α) - Interleukins (IL-) -1, 6, 8

Maximilien Gourdin and Philippe Dubois

http://dx.doi.org/10.5772/54509

**1. Introduction**

consequences of ischemia.

Additional information is available at the end of the chapter
