“The whole of science is nothing more than a refinement of everyday thinking.”

Albert Einstein, Physics and Reality, 1936

The conduct of successful cardiopulmonary bypass is evaluated through quantifiable effects with the ultimate goal of improving a patient’s quality-of-life. Much of what we know concerning extracorporeal flow has been derived from the numerous procedures that have been performed on patients with atherosclerosis of the coronary arteries. Improvements to both the cardiopulmonary bypass circuit and techniques of perfusion have come mainly from the large number of patients who have underwent coronary artery bypass grafting. Yet, there are a large number of procedures that are performed on patients presenting with a malady that could be described as something other than ‘routine’.

In this issue several authors share their results in treating patients that underwent cardiopulmonary support for lesions uncommonly encountered in clinical practice. The papers are presented in the Case Reports section of the Journal and underline the importance of this format for sharing techniques, that for the most part, have not undergone critical review through the tried and true scientific validation of a randomized clinical trial. The use of case review, therefore, suffers from the lack of statistical verification and incorporation of reported technique becomes the judgement of the reader. However, case reports rarely, if ever, describe a technique that is neither capricious nor maldirected. Indeed, the authors describe a treatment plan that evolved from a search of the peer-reviewed literature and integration of methods gleaned from reputable sources. Of course, clinical judgement that involves the entire cardiac surgical team is intimately applied as well. It is from such reporting that the clinical community ‘chips away’ at the daunting challenges that rarely find their way into standardized texts on cardiopulmonary bypass.

Articles of Interest

In this issue Rick Smith introduces the section titled Articles of Interest. An undertaking of this magnitude is always challenging as anyone who has spent time browsing the current periodical section in a medical school library, or via the Internet in electronic citation databases can attest. Rick has nicely summarized the recent literature (only one citation has a pre-2001 publication date) and abstracted several of the more pertinent articles. In the future this section will report, on a quarterly basis, the seminal articles that influence the conduct of cardiopulmonary bypass.

JECT Website

And finally, the editorial staff is pleased to announce the opening of the JECT website. Due to the tremendous efforts of Bruce Searles and Carl Barringer, the site is now online. JECT is also accessible from the AmSECT website. I encourage all to visit the location and browse its contents. As with all aspects of this publication, your comments and criticisms are greatly appreciated.

Sincerely,

Alfred H. Stammers, MSA, CCP

Editor