notes of common surgeries of cranium and brain

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Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):

Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)

Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.

Which of these would you like detailed notes on (indications, steps, complications, imaging)?

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Which cranial/brain surgery topic should I go deep on?

Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):

Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)

Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.

Which of these would you like detailed notes on (indications, steps, complications, imaging)?

burn complete notes

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Burns — Complete Notes: Topic Map

Burns is a broad surgical/emergency medicine topic. Here's the map of what "complete notes" would cover, drawn from Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, and Sabiston Textbook of Surgery:

Classification of Burns - by depth (superficial/epidermal, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting (split-thickness), flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, long-term physiotherapy

Overview: Burns are tissue injuries from thermal, chemical, electrical, or radiation sources, classified primarily by depth and extent (%TBSA). Management follows a sequence: immediate first aid and airway protection, accurate assessment of depth and area, aggressive fluid resuscitation for major burns (using formulas like Parkland), and ongoing wound care ranging from dressings for superficial burns to surgical excision and grafting for full-thickness burns. The systemic inflammatory response in major burns causes capillary leak, hypovolemia, and a hypermetabolic state that drives most of the morbidity and mortality, making early recognition and fluid management critical alongside eventual surgical closure of the wound.

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Which burns topic should I go deep on?

Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):

Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)

Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.

Which of these would you like detailed notes on (indications, steps, complications, imaging)?## Burns — Complete Notes: Topic Map

Burns is a broad surgical/emergency medicine topic. Here's the map of what "complete notes" would cover, drawn from Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, and Sabiston Textbook of Surgery:

Classification of Burns - by depth (superficial/epidermal, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting (split-thickness), flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, long-term physiotherapy

Overview: Burns are tissue injuries from thermal, chemical, electrical, or radiation sources, classified primarily by depth and extent (%TBSA). Management follows a sequence: immediate first aid and airway protection, accurate assessment of depth and area, aggressive fluid resuscitation for major burns (using formulas like Parkland), and ongoing wound care ranging from dressings for superficial burns to surgical excision and grafting for full-thickness burns. The systemic inflammatory response in major burns causes capillary leak, hypovolemia, and a hypermetabolic state that drives most of the morbidity and mortality, making early recognition and fluid management critical alongside eventual surgical closure of the wound.

full notes

Burns — Complete Notes: Topic Map

Since "full notes" follows our burns discussion, here's the topic map again for full/complete notes on burns:

Classification of Burns - by depth (superficial, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting, flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, physiotherapy

Overview: Burns are classified mainly by depth and extent (%TBSA), which together determine severity and treatment path. Management proceeds in sequence: immediate first aid and airway protection, accurate depth/area assessment, fluid resuscitation for major burns (Parkland formula), and wound care ranging from simple dressings for superficial burns to surgical excision and skin grafting for full-thickness burns. The systemic inflammatory response causes capillary leak and a hypermetabolic state driving most complications, so early fluid management and infection control are as important as eventual surgical wound closure.

This is too broad to write out in full as one note. Pick a topic below and I'll go deep on it.

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Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):

Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)

Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.

Which of these would you like detailed notes on (indications, steps, complications, imaging)?## Burns — Complete Notes: Topic Map

Burns is a broad surgical/emergency medicine topic. Here's the map of what "complete notes" would cover, drawn from Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, and Sabiston Textbook of Surgery:

Classification of Burns - by depth (superficial/epidermal, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting (split-thickness), flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, long-term physiotherapy

Overview: Burns are tissue injuries from thermal, chemical, electrical, or radiation sources, classified primarily by depth and extent (%TBSA). Management follows a sequence: immediate first aid and airway protection, accurate assessment of depth and area, aggressive fluid resuscitation for major burns (using formulas like Parkland), and ongoing wound care ranging from dressings for superficial burns to surgical excision and grafting for full-thickness burns. The systemic inflammatory response in major burns causes capillary leak, hypovolemia, and a hypermetabolic state that drives most of the morbidity and mortality, making early recognition and fluid management critical alongside eventual surgical closure of the wound.## Burns — Complete Notes: Topic Map

Since "full notes" follows our burns discussion, here's the topic map again for full/complete notes on burns:

Classification of Burns - by depth (superficial, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting, flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, physiotherapy

Overview: Burns are classified mainly by depth and extent (%TBSA), which together determine severity and treatment path. Management proceeds in sequence: immediate first aid and airway protection, accurate depth/area assessment, fluid resuscitation for major burns (Parkland formula), and wound care ranging from simple dressings for superficial burns to surgical excision and skin grafting for full-thickness burns. The systemic inflammatory response causes capillary leak and a hypermetabolic state driving most complications, so early fluid management and infection control are as important as eventual surgical wound closure.

This is too broad to write out in full as one note. Pick a topic below and I'll go deep on it.

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Rule of Nines burn total body surface area diagram

Burns – Complete Notes

1. Definition & Classification

Burns are injuries to skin/tissue caused by thermal, chemical, electrical, or radiation energy.

By cause:

Thermal (flame, scald, contact)
Chemical (acid/alkali)
Electrical (low/high voltage)
Radiation

By depth (Bailey & Love's Short Practice of Surgery):

Depth	Old term	Appearance	Sensation	Healing
Epidermal	1st degree	Red, dry, no blisters	Painful	5-10 days, no scar
Superficial partial-thickness	2nd degree (superficial)	Red, blistered, weeping	Very painful	2-3 weeks, minimal scar
Deep partial-thickness	2nd degree (deep)	Blotchy red/white, less moist	Reduced pain	3-8 weeks, scarring likely
Full-thickness	3rd degree	White/waxy/leathery/charred, dry	Painless (nerve endings destroyed)	Will not heal spontaneously - needs grafting
Fourth-degree	-	Extends into muscle/bone/tendon	Painless	Requires extensive reconstruction/amputation

2. Assessment of Severity

Extent - % Total Body Surface Area (TBSA):

Rule of Nines (adults): head+neck 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, perineum 1%. Less accurate in children because head is proportionally larger.
Lund-Browder chart: more accurate, adjusts proportions for age - preferred in children.
Palmar surface method: patient's palm = ~1% TBSA, useful for quick/patchy burns.
Only second-degree and deeper burns are counted toward %TBSA for fluid calculations.

Signs of inhalation injury: facial burns, singed nasal hairs, soot in mouth/sputum, hoarseness, stridor, history of enclosed-space fire.

American Burn Association criteria for burn center transfer: partial-thickness burns >10% TBSA, burns to face/hands/feet/genitalia/perineum/major joints, full-thickness burns any age, electrical burns, chemical burns, inhalation injury, burns with comorbidities, burns with concomitant trauma.

3. Pathophysiology

Local response (Jackson's burn wound model):

Zone of coagulation (center) - irreversible cell death
Zone of stasis - sluggish circulation, potentially salvageable, converts to necrosis if inadequately resuscitated/infected
Zone of hyperemia - increased blood flow, will recover

Systemic response (in burns >20-30% TBSA):

Massive capillary leak/increased permeability -> hypovolemia and edema ("burn shock")
Release of inflammatory mediators (cytokines, prostaglandins)
Hypermetabolic state - increased catabolism, muscle wasting
Immunosuppression -> high infection risk
Gastric mucosal ischemia can cause Curling's ulcer (stress gastritis specific to burns >20-30% TBSA)

4. Initial Management / First Aid

Stop the burning process; remove clothing/jewelry
Cool the burn with running water (not ice) for 20 minutes if within 3 hours
ABCDE approach: Airway (early intubation if inhalation injury suspected - airway swells rapidly), Breathing (100% O2, consider carbon monoxide/cyanide poisoning), Circulation (IV access, fluid resuscitation), Disability, Exposure (keep patient warm, prevent hypothermia)
Escharotomy: surgical incision through full-thickness eschar in circumferential burns of limbs/chest/neck to relieve compartment pressure and restore perfusion/ventilation - an emergency procedure, done at bedside without anesthesia (burned tissue is insensate)
Fasciotomy if deeper compartment syndrome (common in electrical burns)
Tetanus prophylaxis

5. Fluid Resuscitation

Given for burns generally >15-20% TBSA in adults (>10% in children).

Parkland formula (most widely used):

Total 24-hour crystalloid (Ringer's lactate) = 4 mL x weight (kg) x %TBSA burned
Half given in the first 8 hours from time of burn, remaining half over next 16 hours
Modified Brooke formula uses 2 mL/kg/%TBSA as an alternative

Monitoring adequacy: urine output (target ~0.5 mL/kg/hr in adults, 1 mL/kg/hr in children), heart rate, mentation, base excess/lactate. Over-resuscitation ("fluid creep") risks pulmonary edema and abdominal compartment syndrome, so formulas are only a starting point and are titrated to response.

6. Wound Management

Superficial burns: simple dressings, moisturizers, analgesia
Partial-thickness burns: topical antimicrobials (silver sulfadiazine, silver-impregnated dressings), non-adherent dressings, blister management
Regular debridement of devitalized tissue and dressing changes
Nutritional support - hypermetabolic state requires high-calorie, high-protein intake (enteral feeding started early)

7. Surgical Management

Early tangential excision of dead tissue down to viable bleeding tissue - reduces infection and improves outcomes, ideally within days of injury
Split-thickness skin grafting (autograft) onto excised wound beds - mainstay for full-thickness burns
Temporary coverage options when donor sites are limited: allograft (cadaveric skin), xenograft, biosynthetic skin substitutes, negative-pressure (VAC) therapy
Flap reconstruction for exposed bone/tendon/joint
Early excision and grafting is the standard of care and reduces sepsis, scarring, and length of stay compared to conservative (delayed) treatment

8. Complications

Early: hypovolemic shock, compartment syndrome, acute respiratory distress (especially with inhalation injury), Curling's ulcer
Infection/sepsis - the leading cause of death in burn patients; systemic inflammatory response from the burn itself makes sepsis diagnosis difficult (SIRS criteria poorly discriminate in burns)
Multi-organ failure
Late: hypertrophic scarring and keloids, contractures (across joints, limiting range of motion), heterotopic ossification, psychological sequelae (PTSD, depression, body image issues)

9. Special Types of Burns

Electrical burns: entry/exit wounds may look small on the surface but cause extensive deep tissue/muscle necrosis along the current path ("iceberg effect"); risk of cardiac arrhythmia (ECG monitoring required), rhabdomyolysis with myoglobinuria (risk of acute kidney injury), and compartment syndrome - may require fasciotomy or even amputation in severe high-voltage injuries.
Chemical burns: irrigate copiously with water (exception: certain agents like elemental metals); alkali burns tend to be deeper than acid burns due to liquefactive necrosis; identify the specific agent as some require specific antidotes/neutralizers.
Inhalation injury: carbon monoxide poisoning (treat with 100% oxygen), cyanide toxicity from combustion of synthetic materials, direct thermal/chemical injury to airway causing edema and later ARDS.

10. Rehabilitation

Early mobilization, splinting to prevent contractures, pressure garments and silicone sheeting for scar management, staged reconstructive surgery for contracture release, and long-term psychological support.

Sources: Bailey and Love's Short Practice of Surgery, 28th Ed.; Schwartz's Principles of Surgery, 11th Ed.; Sabiston Textbook of Surgery; Miller's Anesthesia, 10th Ed.; Campbell's Operative Orthopaedics, 15th Ed.; Current Surgical Therapy, 14th Ed.

Let me know if you want me to expand any single section (e.g. a deeper dive on electrical burns, or a printable summary table) or convert these notes into a PDF/Word document.

Corrective surgeries of congenital heart defects, angioplasties, blood vessel grafting, open heart surgeries

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Cardiac & Vascular Surgery — Topic Map

This covers four distinct major areas. Here's the breakdown:

A. Corrective Surgeries for Congenital Heart Defects

Acyanotic defect repairs - ASD closure, VSD closure, PDA ligation/closure, coarctation repair
Cyanotic defect repairs - Tetralogy of Fallot total correction, Transposition of Great Arteries (arterial switch), Truncus arteriosus repair
Single-ventricle palliation pathway - Norwood procedure, Glenn shunt (bidirectional), Fontan procedure (for hypoplastic left heart syndrome, tricuspid atresia)
Palliative shunts - Blalock-Taussig shunt (for cyanotic defects awaiting definitive repair)

B. Angioplasty

Percutaneous Transluminal Angioplasty (PTA) - balloon dilation of stenosed arteries, mechanism and technique
Coronary angioplasty / PCI - balloon angioplasty with stenting for coronary artery disease
Angioplasty in other vascular beds - renal, pulmonary, peripheral, carotid/intracranial

C. Blood Vessel Grafting

Graft types - autograft (saphenous vein, radial artery), allograft, synthetic grafts (Dacron, PTFE/Gore-Tex)
Common procedures - CABG (coronary artery bypass grafting), peripheral arterial bypass (femoropopliteal, aortoiliac), AV fistula/graft for dialysis access, aortic graft repair for aneurysm

D. Open Heart Surgery

Cardiopulmonary bypass - the machine, cannulation, cardioplegia, technique fundamentals
Valve surgery - valve replacement (mechanical/bioprosthetic) and valve repair
CABG (overlaps with grafting above) as the most common open-heart procedure
Complications & post-op care for cardiac surgery in general

Brief overview: Congenital heart defect surgery ranges from simple hole closures (ASD/VSD/PDA) to complex staged reconstructions for single-ventricle physiology. Angioplasty is a catheter-based, minimally invasive technique using balloon dilation (often with stenting) to open narrowed vessels, used across coronary, peripheral, and other vascular beds, avoiding open surgery. Blood vessel grafting bypasses or replaces diseased/blocked vessels using the patient's own vein/artery or synthetic material, most famously in CABG. Open heart surgery refers to any procedure requiring the heart to be stopped and blood rerouted through a cardiopulmonary bypass machine, encompassing valve repair/replacement, CABG, and congenital defect correction.

Which of these would you like full notes on first?

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Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):

Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)

Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.

Which of these would you like detailed notes on (indications, steps, complications, imaging)?## Burns — Complete Notes: Topic Map

Burns is a broad surgical/emergency medicine topic. Here's the map of what "complete notes" would cover, drawn from Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, and Sabiston Textbook of Surgery:

Classification of Burns - by depth (superficial/epidermal, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting (split-thickness), flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, long-term physiotherapy

Overview: Burns are tissue injuries from thermal, chemical, electrical, or radiation sources, classified primarily by depth and extent (%TBSA). Management follows a sequence: immediate first aid and airway protection, accurate assessment of depth and area, aggressive fluid resuscitation for major burns (using formulas like Parkland), and ongoing wound care ranging from dressings for superficial burns to surgical excision and grafting for full-thickness burns. The systemic inflammatory response in major burns causes capillary leak, hypovolemia, and a hypermetabolic state that drives most of the morbidity and mortality, making early recognition and fluid management critical alongside eventual surgical closure of the wound.## Burns — Complete Notes: Topic Map

Since "full notes" follows our burns discussion, here's the topic map again for full/complete notes on burns:

Classification of Burns - by depth (superficial, superficial partial-thickness, deep partial-thickness, full-thickness) and by cause (thermal, scald, flame, chemical, electrical, radiation)
Assessment of Burn Severity - % Total Body Surface Area (Rule of Nines, Lund-Browder chart), depth assessment, inhalation injury signs
Pathophysiology - local response (zones of coagulation/stasis/hyperemia) and systemic response (burn shock, capillary leak, hypermetabolism)
Initial Management / First Aid - cooling, airway management, ABCDE approach, escharotomy for circumferential burns
Fluid Resuscitation - Parkland formula and other formulas, monitoring urine output
Wound Management - dressings, topical antimicrobials (silver sulfadiazine etc.), debridement
Surgical Management - escharotomy, fasciotomy, tangential excision, skin grafting, flap coverage
Complications - infection/sepsis, contractures, Curling's ulcer, compartment syndrome, multi-organ failure, hypertrophic scarring/keloids
Special Burns - electrical burns, chemical burns, inhalation injury
Rehabilitation and Reconstruction - scar management, contracture release, physiotherapy

Overview: Burns are classified mainly by depth and extent (%TBSA), which together determine severity and treatment path. Management proceeds in sequence: immediate first aid and airway protection, accurate depth/area assessment, fluid resuscitation for major burns (Parkland formula), and wound care ranging from simple dressings for superficial burns to surgical excision and skin grafting for full-thickness burns. The systemic inflammatory response causes capillary leak and a hypermetabolic state driving most complications, so early fluid management and infection control are as important as eventual surgical wound closure.

This is too broad to write out in full as one note. Pick a topic below and I'll go deep on it.# Burns – Complete Notes

1. Definition & Classification

Burns are injuries to skin/tissue caused by thermal, chemical, electrical, or radiation energy.

By cause:

Thermal (flame, scald, contact)
Chemical (acid/alkali)
Electrical (low/high voltage)
Radiation

By depth (Bailey & Love's Short Practice of Surgery):

Depth	Old term	Appearance	Sensation	Healing
Epidermal	1st degree	Red, dry, no blisters	Painful	5-10 days, no scar
Superficial partial-thickness	2nd degree (superficial)	Red, blistered, weeping	Very painful	2-3 weeks, minimal scar
Deep partial-thickness	2nd degree (deep)	Blotchy red/white, less moist	Reduced pain	3-8 weeks, scarring likely
Full-thickness	3rd degree	White/waxy/leathery/charred, dry	Painless (nerve endings destroyed)	Will not heal spontaneously - needs grafting
Fourth-degree	-	Extends into muscle/bone/tendon	Painless	Requires extensive reconstruction/amputation

2. Assessment of Severity

Extent - % Total Body Surface Area (TBSA):

Rule of Nines (adults): head+neck 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, perineum 1%. Less accurate in children because head is proportionally larger.
Lund-Browder chart: more accurate, adjusts proportions for age - preferred in children.
Palmar surface method: patient's palm = ~1% TBSA, useful for quick/patchy burns.
Only second-degree and deeper burns are counted toward %TBSA for fluid calculations.

Signs of inhalation injury: facial burns, singed nasal hairs, soot in mouth/sputum, hoarseness, stridor, history of enclosed-space fire.

American Burn Association criteria for burn center transfer: partial-thickness burns >10% TBSA, burns to face/hands/feet/genitalia/perineum/major joints, full-thickness burns any age, electrical burns, chemical burns, inhalation injury, burns with comorbidities, burns with concomitant trauma.

3. Pathophysiology

Local response (Jackson's burn wound model):

Zone of coagulation (center) - irreversible cell death
Zone of stasis - sluggish circulation, potentially salvageable, converts to necrosis if inadequately resuscitated/infected
Zone of hyperemia - increased blood flow, will recover

Systemic response (in burns >20-30% TBSA):

Massive capillary leak/increased permeability -> hypovolemia and edema ("burn shock")
Release of inflammatory mediators (cytokines, prostaglandins)
Hypermetabolic state - increased catabolism, muscle wasting
Immunosuppression -> high infection risk
Gastric mucosal ischemia can cause Curling's ulcer (stress gastritis specific to burns >20-30% TBSA)

4. Initial Management / First Aid

Stop the burning process; remove clothing/jewelry
Cool the burn with running water (not ice) for 20 minutes if within 3 hours
ABCDE approach: Airway (early intubation if inhalation injury suspected - airway swells rapidly), Breathing (100% O2, consider carbon monoxide/cyanide poisoning), Circulation (IV access, fluid resuscitation), Disability, Exposure (keep patient warm, prevent hypothermia)
Escharotomy: surgical incision through full-thickness eschar in circumferential burns of limbs/chest/neck to relieve compartment pressure and restore perfusion/ventilation - an emergency procedure, done at bedside without anesthesia (burned tissue is insensate)
Fasciotomy if deeper compartment syndrome (common in electrical burns)
Tetanus prophylaxis

5. Fluid Resuscitation

Given for burns generally >15-20% TBSA in adults (>10% in children).

Parkland formula (most widely used):

Total 24-hour crystalloid (Ringer's lactate) = 4 mL x weight (kg) x %TBSA burned
Half given in the first 8 hours from time of burn, remaining half over next 16 hours
Modified Brooke formula uses 2 mL/kg/%TBSA as an alternative

Monitoring adequacy: urine output (target ~0.5 mL/kg/hr in adults, 1 mL/kg/hr in children), heart rate, mentation, base excess/lactate. Over-resuscitation ("fluid creep") risks pulmonary edema and abdominal compartment syndrome, so formulas are only a starting point and are titrated to response.

6. Wound Management

Superficial burns: simple dressings, moisturizers, analgesia
Partial-thickness burns: topical antimicrobials (silver sulfadiazine, silver-impregnated dressings), non-adherent dressings, blister management
Regular debridement of devitalized tissue and dressing changes
Nutritional support - hypermetabolic state requires high-calorie, high-protein intake (enteral feeding started early)

7. Surgical Management

Early tangential excision of dead tissue down to viable bleeding tissue - reduces infection and improves outcomes, ideally within days of injury
Split-thickness skin grafting (autograft) onto excised wound beds - mainstay for full-thickness burns
Temporary coverage options when donor sites are limited: allograft (cadaveric skin), xenograft, biosynthetic skin substitutes, negative-pressure (VAC) therapy
Flap reconstruction for exposed bone/tendon/joint
Early excision and grafting is the standard of care and reduces sepsis, scarring, and length of stay compared to conservative (delayed) treatment

8. Complications

Early: hypovolemic shock, compartment syndrome, acute respiratory distress (especially with inhalation injury), Curling's ulcer
Infection/sepsis - the leading cause of death in burn patients; systemic inflammatory response from the burn itself makes sepsis diagnosis difficult (SIRS criteria poorly discriminate in burns)
Multi-organ failure
Late: hypertrophic scarring and keloids, contractures (across joints, limiting range of motion), heterotopic ossification, psychological sequelae (PTSD, depression, body image issues)

9. Special Types of Burns

Electrical burns: entry/exit wounds may look small on the surface but cause extensive deep tissue/muscle necrosis along the current path ("iceberg effect"); risk of cardiac arrhythmia (ECG monitoring required), rhabdomyolysis with myoglobinuria (risk of acute kidney injury), and compartment syndrome - may require fasciotomy or even amputation in severe high-voltage injuries.
Chemical burns: irrigate copiously with water (exception: certain agents like elemental metals); alkali burns tend to be deeper than acid burns due to liquefactive necrosis; identify the specific agent as some require specific antidotes/neutralizers.
Inhalation injury: carbon monoxide poisoning (treat with 100% oxygen), cyanide toxicity from combustion of synthetic materials, direct thermal/chemical injury to airway causing edema and later ARDS.

10. Rehabilitation

Early mobilization, splinting to prevent contractures, pressure garments and silicone sheeting for scar management, staged reconstructive surgery for contracture release, and long-term psychological support.

Sources: Bailey and Love's Short Practice of Surgery, 28th Ed.; Schwartz's Principles of Surgery, 11th Ed.; Sabiston Textbook of Surgery; Miller's Anesthesia, 10th Ed.; Campbell's Operative Orthopaedics, 15th Ed.; Current Surgical Therapy, 14th Ed.

Let me know if you want me to expand any single section (e.g. a deeper dive on electrical burns, or a printable summary table) or convert these notes into a PDF/Word document.# Cardiac & Vascular Surgery — Topic Map

This covers four distinct major areas. Here's the breakdown:

A. Corrective Surgeries for Congenital Heart Defects

Acyanotic defect repairs - ASD closure, VSD closure, PDA ligation/closure, coarctation repair
Cyanotic defect repairs - Tetralogy of Fallot total correction, Transposition of Great Arteries (arterial switch), Truncus arteriosus repair
Single-ventricle palliation pathway - Norwood procedure, Glenn shunt (bidirectional), Fontan procedure (for hypoplastic left heart syndrome, tricuspid atresia)
Palliative shunts - Blalock-Taussig shunt (for cyanotic defects awaiting definitive repair)

B. Angioplasty

Percutaneous Transluminal Angioplasty (PTA) - balloon dilation of stenosed arteries, mechanism and technique
Coronary angioplasty / PCI - balloon angioplasty with stenting for coronary artery disease
Angioplasty in other vascular beds - renal, pulmonary, peripheral, carotid/intracranial

C. Blood Vessel Grafting

Graft types - autograft (saphenous vein, radial artery), allograft, synthetic grafts (Dacron, PTFE/Gore-Tex)
Common procedures - CABG (coronary artery bypass grafting), peripheral arterial bypass (femoropopliteal, aortoiliac), AV fistula/graft for dialysis access, aortic graft repair for aneurysm

D. Open Heart Surgery

Cardiopulmonary bypass - the machine, cannulation, cardioplegia, technique fundamentals
Valve surgery - valve replacement (mechanical/bioprosthetic) and valve repair
CABG (overlaps with grafting above) as the most common open-heart procedure
Complications & post-op care for cardiac surgery in general

Brief overview: Congenital heart defect surgery ranges from simple hole closures (ASD/VSD/PDA) to complex staged reconstructions for single-ventricle physiology. Angioplasty is a catheter-based, minimally invasive technique using balloon dilation (often with stenting) to open narrowed vessels, used across coronary, peripheral, and other vascular beds, avoiding open surgery. Blood vessel grafting bypasses or replaces diseased/blocked vessels using the patient's own vein/artery or synthetic material, most famously in CABG. Open heart surgery refers to any procedure requiring the heart to be stopped and blood rerouted through a cardiopulmonary bypass machine, encompassing valve repair/replacement, CABG, and congenital defect correction.

Which of these would you like full notes on first?

Finding Sources

Cardiac & Vascular Surgery – Complete Notes

A. Corrective Surgeries for Congenital Heart Defects

General principle: Defects are corrected either by direct closure/reconstruction (definitive repair) or, when the heart cannot support a normal two-ventricle circulation, by staged palliation that reroutes venous blood directly to the lungs.

1. Acyanotic defects (left-to-right shunts)

ASD (Atrial Septal Defect) closure: primary suture closure or patch closure (pericardial/synthetic) via sternotomy and cardiopulmonary bypass (CPB); many secundum ASDs now closed percutaneously with a device (Amplatzer septal occluder) via cardiac catheterization.
VSD (Ventricular Septal Defect) closure: via right atriotomy or ventriculotomy on CPB, patch closure with running suture over the defect; muscular VSDs can be closed percutaneously with a device occluder.
PDA (Patent Ductus Arteriosus): surgical ligation/division (via left thoracotomy) or percutaneous coil/device occlusion; historically the first successful congenital heart operation (1938).
Coarctation of aorta repair: resection with end-to-end anastomosis, patch aortoplasty, or subclavian flap repair; balloon angioplasty +/- stenting used for recurrent coarctation.

2. Cyanotic defects

Tetralogy of Fallot (TOF) total correction: closes the VSD with a patch and relieves right ventricular outflow tract (pulmonary) obstruction by resecting infundibular muscle and patching the outflow tract/pulmonary annulus (transventricular or transatrial approach). Performed in infancy on CPB. Historically staged with a palliative shunt first; now often done as primary repair.
Transposition of the Great Arteries (TGA): Arterial switch operation (Jatene procedure) - transects and switches the aorta and pulmonary artery back to their correct ventricles with coronary artery reimplantation; has replaced the older atrial-switch (Mustard/Senning) procedures.
Truncus arteriosus repair: closes the VSD, separates the pulmonary arteries from the common trunk, and places a conduit from the right ventricle to the pulmonary arteries.

3. Single-ventricle palliation pathway (staged, e.g. hypoplastic left heart syndrome)

Stage 1 - Norwood procedure (neonatal period): reconstructs a single functional aorta from the pulmonary artery/native aorta, and provides pulmonary blood flow via a Blalock-Taussig shunt (subclavian-to-pulmonary artery) or right ventricle-to-pulmonary artery conduit (Sano modification).
Stage 2 - Bidirectional Glenn shunt / hemi-Fontan (3-6 months): connects the superior vena cava directly to the pulmonary artery, reducing volume load on the single ventricle (saturations ~80%).
Stage 3 - Fontan completion (2-4 years): connects the inferior vena cava to the pulmonary artery (often via an extracardiac conduit or lateral tunnel), completing separation of systemic and pulmonary circulations so the single ventricle only pumps to the body.

4. Palliative shunts

Blalock-Taussig shunt: a conduit (originally subclavian artery, now usually a Gore-Tex tube graft) from a systemic artery to the pulmonary artery, used to increase pulmonary blood flow in cyanotic defects awaiting definitive repair.

B. Angioplasty

Definition: A catheter-based, minimally invasive technique to widen a narrowed or occluded blood vessel using a balloon-tipped catheter, often followed by stent placement to maintain patency.

Technique:

Vascular access (usually femoral or radial artery), guidewire advanced across the stenosis under fluoroscopy
Balloon catheter positioned across the lesion and inflated, compressing/fracturing the atherosclerotic plaque and stretching the vessel wall
A stent (bare metal or drug-eluting) is often deployed to scaffold the vessel and prevent elastic recoil/restenosis - traditionally reserved for residual stenosis >30% after balloon dilation alone, but now used routinely in coronary work
Post-procedure antiplatelet therapy (dual antiplatelet therapy for drug-eluting stents) to prevent thrombosis

Applications:

Coronary angioplasty (PCI - Percutaneous Coronary Intervention): for coronary artery disease/acute MI, an alternative to CABG for suitable lesions
Peripheral angioplasty: for peripheral arterial disease (femoropopliteal, aortoiliac occlusive disease)
Renal artery angioplasty: for renal artery stenosis (especially fibromuscular dysplasia - balloon angioplasty without stent is preferred here)
Carotid/intracranial angioplasty: for symptomatic carotid or intracranial stenosis
Pulmonary (balloon) angioplasty: for chronic thromboembolic pulmonary hypertension
Dialysis access salvage: balloon angioplasty (or stent-graft) for AV fistula/graft stenosis

Complications: restenosis, vessel dissection, distal embolization, access-site hematoma/pseudoaneurysm, contrast nephropathy.

C. Blood Vessel Grafting

Purpose: to bypass an obstructed segment or replace a diseased vessel, restoring distal blood flow.

Graft materials:

Autograft (patient's own tissue) - gold standard for durability and patency:
- Great saphenous vein - most common conduit for CABG and lower-limb bypass
- Internal mammary (thoracic) artery (LIMA/BIMA) - best long-term patency for CABG, especially to the LAD
- Radial artery - alternative arterial conduit
Allograft - cadaveric vessel, less common
Synthetic grafts - Dacron (woven polyester) or PTFE (Gore-Tex/expanded PTFE) - used when autologous conduit is unavailable or for large-caliber vessels (aorta)

Common procedures:

CABG (Coronary Artery Bypass Grafting): grafts (LIMA to LAD is standard; saphenous vein or radial artery for other vessels) routed from the aorta (or subclavian artery for LIMA) to a coronary artery beyond the blockage; performed via median sternotomy on CPB (or "off-pump"/beating-heart, and increasingly via minimally invasive/robotic approaches - MIDCAB, TECAB)
Peripheral arterial bypass: e.g. femoropopliteal bypass, aortobifemoral bypass for aortoiliac occlusive disease, using vein or synthetic graft
AV fistula/graft creation: for hemodialysis access - autologous fistula (radiocephalic, brachiocephalic) preferred over synthetic AV grafts due to better long-term patency
Aortic graft repair: synthetic (Dacron) tube or bifurcated graft to replace/exclude an aortic aneurysm (open repair) or endovascular stent-grafts (EVAR) for the same purpose

Patency comparison: internal mammary artery grafts have superior long-term patency compared to saphenous vein grafts, which are more prone to intimal hyperplasia and late atherosclerotic degeneration.

D. Open Heart Surgery

Definition: any cardiac operation requiring the heart to be stopped (or supported) while blood circulation and oxygenation are maintained mechanically, allowing the surgeon to operate inside/on the heart.

1. Cardiopulmonary Bypass (CPB) - the core technique

Cannulation: venous cannula(e) placed in the right atrium/vena cavae to drain blood, arterial cannula in the aorta to return oxygenated blood
The CPB circuit: venous blood drains by gravity/vacuum into a reservoir, passes through an oxygenator (membrane oxygenator) and heat exchanger, then is pumped back into the arterial system - effectively substituting for the heart and lungs
Heparinization: full anticoagulation before cannulation, reversed with protamine after bypass
Aortic cross-clamping: the ascending aorta is clamped to create a bloodless, still operative field in the heart
Cardioplegia: a potassium-rich solution (antegrade via aortic root, or retrograde via coronary sinus) is delivered to arrest the heart in diastole and protect the myocardium from ischemic injury during the cross-clamp period
After the repair, the patient is rewarmed, air is removed from the heart chambers ("de-airing"), the cross-clamp is released, and the patient is weaned off bypass

2. Common open-heart procedures

CABG (see above) - most common open-heart operation
Valve surgery:
- Valve replacement: mechanical valves (durable, require lifelong anticoagulation) vs bioprosthetic/tissue valves (no long-term anticoagulation needed, but degenerate over 10-15 years)
- Valve repair: preferred when feasible (e.g. mitral valve repair for prolapse/regurgitation) - preserves native tissue and avoids prosthesis-related complications
Congenital defect correction (see Section A) - most performed on CPB
Heart transplantation: median sternotomy, bicaval anastomosis technique, minimizing ischemic and CPB time is critical

3. Complications of cardiac surgery / CPB

Low cardiac output syndrome (risk factors: pre-op LV dysfunction, long cross-clamp/CPB time, inadequate repair, ischemia-reperfusion injury)
Bleeding/coagulopathy from heparinization and CPB-induced platelet dysfunction
Stroke/neurocognitive dysfunction (embolic or hypoperfusion related)
Arrhythmias (especially post-op atrial fibrillation)
Acute kidney injury
Systemic inflammatory response from CPB circuit contact activation
Sternal wound infection/mediastinitis

4. Minimally invasive alternatives

Off-pump CABG (OPCAB): performed on the beating heart using stabilizer devices, avoiding CPB-related complications
MIDCAB / TECAB / Robotic-assisted CABG: smaller incisions, sometimes avoiding sternotomy entirely
TAVI/TAVR (transcatheter aortic valve implantation): catheter-based valve replacement without CPB, for high-risk surgical candidates

Sources: Sabiston Textbook of Surgery; Schwartz's Principles of Surgery, 11th Ed.; Mulholland and Greenfield's Surgery; Fuster and Hurst's The Heart, 15th Ed.; Bailey and Love's Short Practice of Surgery, 28th Ed.; Miller's Anesthesia, 10th Ed.; The Harriet Lane Handbook, 23rd Ed.

Tell me if you'd like any of these four sections expanded further (e.g. a step-by-step operative sequence for a specific procedure, or a comparison table of valve types/graft conduits).