Handbook of Cardiac Anatomy, Physiology,and Devices

Paul A. Iaizzo

Editor

Handbook of CardiacAnatomy, Physiology,and Devices

Second Edition

Foreword by Timothy G. Laske

1 3

EditorPaul A. IaizzoUniversity of MinnesotaDepartment of SurgeryB172 Mayo, MMC 195420 Delaware St. SE.,Minneapolis, MN 55455USAiaizz001@umn.edu

ISBN 978-1-60327-371-8 e-ISBN 978-1-60327-372-5DOI 10.1007/978-1-60327-372-5

Library of Congress Control Number: 2009920269

# Springer ScienceþBusiness Media, LLC 2009All rights reserved. This work may not be translated or copied in whole or in part without the written permissionof the publisher (Springer ScienceþBusiness Media, LLC, 233 Spring Street, New York, NY 10013, USA),except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form ofinformation storage and retrieval, electronic adaptation, computer software, or by similar or dissimilarmethodology now known or hereafter developed is forbidden.The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are notidentified as such, is not to be taken as an expression of opinion as to whether or not they are subject toproprietary rights.While the advice and information in this book are believed to be true and accurate at the date of going to press,neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors oromissions that may be made. The publisher makes no warranty, express or implied, with respect to thematerial contained herein.

Printed on acid-free paper

Springer is part of Springer ScienceþBusiness Media (www.springer.com)

Foreword

A revolution began in my professional career and education in 1997. In that year, I visited

the University of Minnesota to discuss collaborative opportunities in cardiac anatomy,

physiology, and medical device testing. The meeting was with a faculty member of the

Department of Anesthesiology, Professor Paul Iaizzo. I didn’t know what to expect but,

as always, I remained open minded and optimistic. Little did I know that my life would

never be the same. . . .

During the mid to late 1990s, Paul Iaizzo and his team were performing anesthesia

research on isolated guinea pig hearts. We found the work appealing, but it was unclear

how this research might apply to our interest in tools to aid in the design of implantable

devices for the cardiovascular system. As discussions progressed, we noted that we would

be far more interested in reanimation of large mammalian hearts, in particular, human

hearts. Paul was confident this could be accomplished on large hearts, but thought that it

would be unlikely that we would ever have access to human hearts for this application.We

shook hands and the collaboration was born in 1997. In the same year, Paul and the

research team at theUniversity ofMinnesota (including Bill Gallagher and Charles Soule)

reanimated several swine hearts. Unlike the previous work on guinea pig hearts which

were reanimated in Langendorff mode, the intention of this research was to produce a

fully functional working heart model for device testing and cardiac research. Such amodel

would allow engineers and scientists easy access to the epicardium and the chambers

through transmural ports. It took numerous attempts to achieve the correct osmotic

balance and an adequately oxygenated perfusate, and to avoid poisoning the preparation

with bacteria (which we found were happy to lurk anywhere and everywhere in the

plumbing of the apparatus). This project required a combination of art, science, and

dogged persistence.

In addition to the breakthrough achieved in the successful animation of numerous

swine hearts, bigger and better things were in store. Serendipitously, when faced with a

need to see inside the heart, the research team found a fiberoptic scope on an upper shelf in

the laboratory. The scope was inserted into the heart and a whole new world was

observed. Due to the clear nature of the perfusate, we immediately saw the flashing of

the tricuspid valve upon insertion of the scope. We were in awe as we viewed the first

images ever recorded inside of a working heart. This is the moment when my personal

revolution began.

The years that have followed have included numerous achievements which I attribute

to the vision and persistence of Paul and the team. The human hearts that Paul initially

considered impossible to access and reanimate were soon functioning in the apparatus due

to a collaboration with LifeSource. Indeed, the team’s ‘‘never say never’’ attitude is at the

heart of their pursuit of excellence in education and research.

v

The Visible Heart Laboratory has evolved into a dream for engineers, educators, and

cardiac physiologists as scientific equipment has been added (echocardiography, electrical

mapping systems, hemodynamic monitors, etc.) and endoscopic video capabilities have

improved (the lab is currently using video endoscopes with media quality recording

equipment). The lab produces educational images, conducts a wide spectrum of cardiac

research, and evaluates current and future medical device concepts each week. Hundreds

of engineers and students have worked and studied in the lab, countless physicians have

assisted with procedures, and thousands of educational CDs/DVDs have been distributed

(free of charge).

Eleven years after the beginning of our collaborative effort, the Visible Heart Labora-

tory remains the only place in the world where a human heart can be reanimated outside of

the body and made to work for an extended period of time. This is a tribute to the efforts

of Paul and his team in managing the difficulty it takes to make this happen. Interestingly,

the team currently works in the laboratory in which Lillehei and Bakken first tested the

battery-powered pacemaker; the ‘‘good karma’’ lives on.

This book is a result of Paul’s passion for excellence in teaching and for innovation in

the medical device field. I am confident that the reader will find this book an invaluable

resource. It is a testament to Paul’s dedication to both education, collaboration, and the

ongoing development of his current and past students.

By the way. . . . The personal revolution I referred to, fueled by my collaboration with

Paul, has included numerous patents, countless device concepts accepted and/or rejected,

several scientific articles, a PhD in Biomedical Engineering, and a collaboration in black

bear hibernation physiology. None of this would have happened had I not met Paul that

day in 1997, and benefited from his friendship and mentoring over the years. I can only

imagine what the future will bring, but you can be rest assured that success is sure to come

to those that associate themselves with Paul Iaizzo.

Minneapolis, MN Timothy G. Laske, Ph. D.

vi Foreword

Preface

Worldwide, the medical device industry continues to grow at an incredibly rapid pace.

Our overall understanding of the molecular basis of disease continues to increase, in

addition to the number of available therapies to treat specific health problems. This

remains particularly true in the field of cardiovascular care. Hence, with this rapid growth

rate, the biomedical engineer has been challenged to both retool and continue to seek out

sources of concise information.

The major impetus for the second edition of this text was to update this resource

textbook for interested students, residents, and/or practicing biomedical engineers. A

secondary motivation was to promote the expertise, past and present, in the area of

cardiovascular sciences at the University of Minnesota. As Director of Education for

The Lillehei Heart Institute and the Associate Director for Education of the Institute for

Engineering in Medicine at the University of Minnesota, I feel that this book also

represents a unique outreach opportunity to carry on the legacies of C. Walton Lillehei

and Earl Bakken through the 21st century. Interestingly, the completion of the textbook

also coincides with two important anniversaries in cardiovascular medicine and engineer-

ing at the University of Minnesota. First, it was 50 years ago, in 1958, that the first

wearable, battery-powered pacemaker, built by Earl Bakken (and Medtronic) at the

request of Dr. Lillehei, was first used on a patient. Second, 30 years ago, in 1978, the

first human heart transplantation was performed at the University of Minnesota.

For the past 10 years, the University of Minnesota has presented the week-long short

course, Advanced Cardiac Physiology and Anatomy, which was designed specifically for

the biomedical engineer working in industry; this is the course textbook. As this course has

evolved, there was a need to update the textbook. For example, six new chapters were

added to this second edition, and all other chapters were either carefully updated and/or

greatly expanded. One last historical note that I feel is interesting to mention is that my

current laboratory, where isolated heart studies are performed weekly (the Visible Heart1

laboratory), is the same laboratory in which C. Walton Lillehei and his many esteemed

colleagues conducted a majority of their cardiovascular research studies in the late 1950s

and early 1960s.

As with the first edition of this book, I have included electronic files on the companion

DVD thatwill enhance this textbook’s utility. Part of the companionDVD, the ‘‘TheVisible

Heart1 Viewer,’’ was developed as a joint venture between my laboratory at the Uni-

versity of Minnesota and the Cardiac Rhythm Management Division at Medtronic, Inc.

Importantly, this electronic textbook also includes functional images of human hearts.

These images were obtained from hearts made available via LifeSource, more specifically

through the generosity of families and individuals whomade the final gift of organ donation

(these hearts were not deemed viable for transplantation). Furthermore, the companion

vii

DVD contains various additional color images and movies that were provided by the

various authors to supplement their chapters. Since the first printing of this textbook,

my laboratory has also developed the free-access website, ‘‘The Atlas of Human Cardiac

Anatomy,’’ that readers of this text should also find valuable as a complementary resource

(http://www.vhlab.umn.edu/atlas).

I would especially like to acknowledge the exceptional efforts of our lab coordinator,

Monica Mahre, who for a second time: (1) assisted me in coordinating the efforts of the

contributing authors; (2) skillfully incorporated my editorial changes; (3) verified the

readability and formatting of each chapter; (4) pursued requested additions or missing

materials for each chapter; (5) contributed as a co-author; and (6) kept a positive outlook

throughout. I would also like to thank Gary Williams for his computer expertise and

assistance with numerous figures; William Gallagher and Charles Soule who made sure

the laboratory kept running smoothly while many of us were busy writing or editing; Dick

Bianco for his support of our lab and this book project; the chairman of the Department

of Surgery, Dr. Selwyn Vickers, for his support and encouragement; and the Institute for

Engineering in Medicine at the University of Minnesota, headed by Dr. Jeffrey McCul-

lough, who supported this project by funding the Cardiovascular Physiology Interest

Group (many group members contributed chapters).

I would like to thankMedtronic, Inc. for their continued support of the Visible Heart1

Laboratory for the past 12 years, and I especially acknowledge the commitments, partner-

ships, and friendships of Drs. Tim Laske, Alex Hill, and Nick Skadsberg for making our

collaborative research possible. In addition, I would like to thank Jilean Welch and Mike

Leners for their creative efforts in producing many of the movie and animation clips that

are on the DVD.

It is also my pleasure to thank the past and present graduate students or residents who

have worked inmy laboratory and whowere contributors to this second edition, including

Sara Anderson, James Coles, Anthony Dupre, Michael Eggen, Kevin Fitzgerald, Alex-

ander Hill, Jason Johnson, Ryan Lahm, Timothy Laske, Anna Legreid Dopp, Michael

Loushin, Jason Quill, Maneesh Shrivastav, Daniel Sigg, Eric Richardson, Nicholas

Skadsberg, and Sarah Vieau. I feel extremely fortunate to have the opportunity to work

with such a talented group of scientists and engineers, and I have learned a great deal from

each of them.

Finally, I would like to thank my family and friends for their continued support of my

career and their assistance over the years. Specifically, I would like to thank my wife,

Marge, my three daughters, Maria, Jenna, and Hanna, my mom Irene, and siblings Mike,

Chris, Mark, and Susan for always being there for me. On a personal note, some of my

inspiration for working on this project comes from the memory of my father, Anthony,

who succumbed to a sudden cardiac event, and from the memory of my Uncle Tom

Halicki, who passed away 9 years after a heart transplantation.

Minneapolis, MN Paul A. Iaizzo

viii Preface

Contents

Part I Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1 General Features of the Cardiovascular System . . . . . . . . . . . . . . . . . . . . . . . . . 3

Paul A. Iaizzo

Part II Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

2 Attitudinally Correct Cardiac Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Alexander J. Hill

3 Cardiac Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Brad J. Martinsen and Jamie L. Lohr

4 Anatomy of the Thoracic Wall, Pulmonary Cavities, and Mediastinum . . . . . . . 33

Mark S. Cook, Kenneth P. Roberts, and Anthony J. Weinhaus

5 Anatomy of the Human Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Anthony J. Weinhaus and Kenneth P. Roberts

6 Comparative Cardiac Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Alexander J. Hill and Paul A. Iaizzo

7 The Coronary Vascular System and Associated Medical Devices . . . . . . . . . . . 109

Sara E. Anderson, Ryan Lahm, and Paul A. Iaizzo

8 The Pericardium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Eric S. Richardson, Alexander J. Hill, Nicholas D. Skadsberg,

Michael Ujhelyi, Yong-Fu Xiao and Paul A. Iaizzo

9 Congenital Defects of the Human Heart: Nomenclature and Anatomy . . . . . . . 137

James D. St. Louis

Part III Physiology and Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

10 Cellular Myocytes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

Vincent A. Barnett

11 The Cardiac Conduction System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

Timothy G. Laske, Maneesh Shrivastav, and Paul A. Iaizzo

12 Autonomic Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177

Kevin Fitzgerald, Robert F. Wilson, and Paul A. Iaizzo

ix

13 Cardiac and Vascular Receptors and Signal Transduction . . . . . . . . . . . . . . . . . 191

Daniel C. Sigg and Ayala Hezi-Yamit

14 Reversible and Irreversible Damage of the Myocardium: New Ischemic

Syndromes, Ischemia/Reperfusion Injury, and Cardioprotection . . . . . . . . . . . . 219

James A. Coles, Daniel C. Sigg, and Paul A. Iaizzo

15 The Effects of Anesthetic Agents on Cardiac Function. . . . . . . . . . . . . . . . . . . . 231

Jason S. Johnson and Michael K. Loushin

16 Blood Pressure, Heart Tones, and Diagnoses . . . . . . . . . . . . . . . . . . . . . . . . . . . 243

George Bojanov

17 Basic ECG Theory, 12-Lead Recordings and Their Interpretation . . . . . . . . . . . 257

Anthony Dupre, Sarah Vieau, and Paul A. Iaizzo

18 Mechanical Aspects of Cardiac Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . 271

Michael K. Loushin, Jason L. Quill, and Paul A. Iaizzo

19 Energy Metabolism in the Normal and Diseased Heart . . . . . . . . . . . . . . . . . . . 297

Arthur H.L. From and Robert J. Bache

20 Introduction to Echocardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

Jamie L. Lohr and Shanthi Sivanandam

21 Monitoring and Managing the Critically Ill Patient in the Intensive

Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331

Greg J. Beilman

22 Cardiovascular Magnetic Resonance Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . 341

Michael D. Eggen and Cory M. Swingen

Part IV Devices and Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

23 A Historical Perspective of Cardiovascular Devices and Techniques

Associated with the University of Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . . . 365

Paul A. Iaizzo and Monica A. Mahre

24 Pharmacotherapy for Cardiac Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383

Anna Legreid Dopp and J. Jason Sims

25 Animal Models for Cardiac Research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393

Richard W. Bianco, Robert P. Gallegos, Andrew L. Rivard,

Jessica Voight, and Agustin P. Dalmasso

26 Catheter Ablation of Cardiac Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411

Xiao-Huan Li and Fei Lu

27 Pacing and Defibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443

Timothy G. Laske, Anna Legreid Dopp, and Paul A. Iaizzo

28 Cardiac Resynchronization Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475

Fei Lu

29 Cardiac Mapping Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499

Nicholas D. Skadsberg, Bin He, Timothy G. Laske, and Paul A. Iaizzo

30 Cardiopulmonary Bypass and Cardioplegia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 511

J. Ernesto Molina

31 Heart Valve Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527

Ranjit John and Kenneth K. Liao

x Contents

32 Less Invasive Cardiac Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551

Kenneth K. Liao

33 Transcatheter Valve Repair and Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . 561

Alexander J. Hill, Timothy G. Laske, and Paul A. Iaizzo

34 Cardiac Septal Defects: Treatment via the Amplatzer1 Family of Devices . . . . 571

John L. Bass and Daniel H. Gruenstein

35 Harnessing Cardiopulmonary Interactions to Improve Circulation

and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure . . . 583

Anja Metzger and Keith Lurie

36 End-Stage Congestive Heart Failure: Ventricular Assist Devices . . . . . . . . . . . . 605

Kenneth K. Liao and Ranjit John

37 Cell Transplantation for Ischemic Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . 613

Mohammad N. Jameel, Joseph Lee, Daniel J. Garry, and Jianyi Zhang

38 Emerging Cardiac Devices and Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . 631

Paul A. Iaizzo

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645

Contents xi

Contributors

Sara E. Anderson, PhD University of Minnesota, Departments of Biomedical

Engineering and Surgery and University of Minnesota, Covidien, 5920 Longbow Dr.,

Boulder, CO 80301, USA, sara.e.anderson1@gmail.com

Robert J. Bache, MD University of Minnesota, Cardiovascular Division, Center for

Magnetic Resonance Research, MMC 508, 420 Delaware St. SE, Minneapolis, MN

55455, USA, bache001@umn.edu

Vincent A. Barnett, PhD University of Minnesota, Department of Integrative Biology

and Physiology, 6-125 Jackson Hall, 321 Church St, SE, Minneapolis, MN 55455, USA,

barne014@umn.edu

John L. Bass, MD University of Minnesota, Department of Pediatric Cardiology, MMC

94, 420 Delaware St. SE, Minneapolis, MN 55455, USA, bassx001@umn.edu

Gregory J. Beilman, MD University of Minnesota, Department of Surgery, MMC 11,

420 Delaware St. SE, Minneapolis, MN 55455, USA, beilm001@umn.edu

Richard W. Bianco University of Minnesota, Experimental Surgical Services,

Department of Surgery, MMC 220, 420 Delaware St. SE, Minneapolis, MN 55455, USA,

bianc001@umn.edu

George Bojanov, MD University of Minnesota, Department of Anesthesiology, MMC

294, 420 Delaware St. SE, Minneapolis, MN 55455, USA, boja0003@umn.edu

James A. Coles, Jr., PhD Medtronic, Inc., 8200 Coral Sea St. NE, MNV41, Mounds

View, MN 55112, USA, james.coles@medtronic.com

Mark S. Cook, PT, PhD University of Minnesota, Department of Integrative Biology

and Physiology, 6-125 Jackson Hall, 321 Church St. SE, Minneapolis, MN 55455, USA,

cookx072@umn.edu

Agustin P. Dalmasso, MD University of Minnesota, Departments of Surgery,

LaboratoryMedicine, and Pathology,MMC220, 420Delaware St. SE,Minneapolis,MN

55455, USA, dalma001@umn.edu

Anna Legreid Dopp, PharmD University of Wisconsin-Madison, School of Pharmacy,

777 Highland Avenue, Madison, WI 58705, USA, alegreiddopp@pharmacy.wisc.edu

Anthony Dupre, MS Boston Scientific Scimed, 1 Scimed Place, Osseo, MN 55311, USA,

tony.dupre@gmail.com

xiii

Michael D. Eggen, PhD University of Minnesota, Departments of Biomedical

Engineering and Surgery, B 172 Mayo, MMC 195, 420 Delaware St. SE, Minneapolis,

MN 55455, USA, egge0075@umn.edu

Kevin Fitzgerald, MS Medtronic, Inc., 1129 Jasmine St., Denver, CO 80220, USA,

kevin.fitzgerald@medtronic.com

Arthur H.L. From, MD University of Minnesota, Cardiovascular Division, Center for

Magnetic Resonance Research, 2021 6th St. SE, Minneapolis, MN 55455, USA,

fromx001@umn.edu

Robert P. Gallegos, MD, PhD Brigham and Women’s Hospital, Division of Cardiac

Surgery, 75 Francis St., Boston, MA 02115, USA, rgallegos@partners.org

Daniel J. Garry, MD, PhD University of Minnesota, Division of Cardiology,

Department of Medicine, MMC 508, 420 Delaware St. SE, Minneapolis, MN 55455,

USA, garry@umn.edu

Daniel H. Gruenstein, MD University of Minnesota, Department of Pediatric

Cardiology, MMC 94, 420 Delaware St. SE, Minneapolis, MN 55455, USA,

gruen040@umn.edu

Bin He, PhD University of Minnesota, Department of Biomedical Engineering, 7-105

BSBE, 312 Church St. SE, Minneapolis, MN 55455, USA, binhe@umn.edu

Ayala Hezi-Yamit, PhD Medtronic, Inc., 3576 Unocal Place, Santa Rosa, CA 95403,

USA, ayala.hezi-yamit@medtronic.com

Alexander J. Hill, PhD University of Minnesota, Departments of Biomedical

Engineering and Surgery, Medtronic, Inc., 8200 Coral Sea St. NE, MVS84, Mounds

View, MN 55112, USA, alex.hill@medtronic.com

Paul A. Iaizzo, PhD University of Minnesota, Department of Surgery, B172 Mayo,

MMC 195, 420 Delaware St. SE, Minneapolis, MN 55455, USA, iaizz001@umn.edu

Mohammad N. Jameel, MD University of Minnesota, Department of Medicine, MMC

508, 420 Delaware St. SE, Minneapolis, MN 55455, USA, jamee001@umn.edu

Ranjit John, MD University of Minnesota, Division of Cardiovascular and Thoracic

Surgery, Department of Surgery, MMC 207, 420 Delaware St. SE, Minneapolis, MN

55455, USA, johnx008@umn.edu

Jason S. Johnson, MD University of Minnesota, Department of Anesthesiology, MMC

294, 420 Delaware St. SE, Minneapolis, MN 55455, USA, john6578@umn.edu

Ryan Lahm, MS Medtronic, Inc., 8200 Coral Sea St. NE, Mail Stop: MVN51, Mounds

View, MN 55112, USA, ryan.lahm@medtronic.com

Timothy G. Laske, PhD University of Minnesota, Department of Surgery and

Medtronic, Inc., 8200 Coral Sea St. NE, MVS84, Mounds View, MN 55112, USA,

tim.g.laske@medtronic.com

Joseph Lee, MD, PhD University of Minnesota, MMC 293, 420 Delaware St. SE,

Minneapolis, MN 55455, USA, joelee@umn.edu

Xiao-huan Li, MD University of Minnesota, Department of Surgery, MMC 195, 420

Delaware St. SE, Minneapolis, MN 55455, USA, lixxx475@umn.edu

Kenneth K. Liao,MD University ofMinnesota, Division of Cardiovascular and Thoracic

Surgery, Department of Surgery, MMC 207, 420 Delaware St. SE, Minneapolis,

MN 55455, USA, liaox014@umn.edu

xiv Contributors

Jamie L. Lohr, MD University of Minnesota, Division of Pediatric Cardiology,

Department of Pediatrics,MMC94, 420Delaware St. SE,Minneapolis,MN55455, USA,

lohrx003@umn.edu

Michael K. Loushin, MD University of Minnesota, Department of Anesthesiology,

MMC 294, 420 Delaware St. SE, Minneapolis, MN 55455, USA, loush001@umn.edu

Fei Lu, MD, PhD, FACC University ofMinnesota, Department ofMedicine, MMC 508,

420 Delaware St. SE, Minneapolis, MN, 55455, USA, luxxx074@umn.edu

Keith Lurie, MD University of Minnesota, Department of Emergency Medicine,

HCMC, 701 Park Ave. S., Minneapolis, MN 55415, USA, lurie002@umn.edu

Monica A. Mahre, BS University of Minnesota, Department of Surgery, B172 Mayo,

MMC 195, 420 Delaware St. SE, Minneapolis, MN 55455, USA, mahre002@umn.edu

Brad J. Martinsen, PhD University of Minnesota, Division of Pediatric Cardiology,

Department of Pediatrics, 1-140 MoosT, 515 Delaware St. SE, Minneapolis, MN 55455,

USA, marti198@umn.edu

Anja Metzger, PhD University of Minnesota, Department of Emergency Medicine,

13683 47th St. N., Minneapolis, MN 55455, USA, ametzger@advancedcirculatory.com

or kohl0005@umn.edu

J. Ernesto Molina, MD, PhD University of Minnesota, Division of Cardiothoracic

Surgery, MMC 207, 420 Delaware St. SE, Minneapolis, MN 55455, USA,

molin001@umn.edu

Jason L. Quill, PhD University of Minnesota, Departments of Biomedical Engineering

and Surgery, B172 Mayo, MMC 195, 420 Delaware St. SE, Minneapolis, MN 55455,

USA, quill010@umn.edu

Eric S. Richardson, PhD University of Minnesota, Departments of Biomedical

Engineering and Surgery, B172 Mayo, MMC 195, 420 Delaware St. SE, Minneapolis,

MN 55455, USA, richa483@umn.edu

Andrew L. Rivard, MD University of Florida, College of Medicine, Department of

Radiology, PO Box 100374, Gainesville, FL 32610-0374, USA,

andrewrivard@hotmail.com

Kenneth P. Roberts, PhD Washington State University-Spokane, WWAMI Medical

Educational Program, 320N Health Sciences Building, PO Box 1495, Spokane, WA

99210, USA, kenroberts@wsu.edu

Maneesh Shrivastav, PhD Medtronic, Inc., 8200 Coral Sea St. NE, MVN42, Mounds

View, MN 55112, USA, paricay@yahoo.com

Daniel C. Sigg, MD, PhD University of Minnesota, Department of Integrative Biology

and Physiology, 1485 Hoyt Ave W, Saint Paul, MN 55108, siggx001@umn.edu

J. Jason Sims, PharmD Medtronic, Inc., 135 Highpoint Pass, Fayettville, GA 30215,

USA, j.jason.sims@medtronic.com

Shanthi Sivanandam, MD University of Minnesota, Division of Pediatric Cardiology,

Department of Pediatrics,MMC94, 420Delaware St. SE,Minneapolis,MN55455, USA,

silv0099@umn.edu

Nicholas D. Skadsberg, PhD Medtronic, Inc., 8200 Coral Sea St. NE,Mounds View,MN

55112, USA, nick.skadsberg@medtronic.com

Contributors xv

James D. St. Louis, MD University of Minnesota, Departments of Surgery and

Pediatrics, MMC 495, 420 Delaware St. SE, Minneapolis, MN 55455, USA,

stlou012@umn.edu

Cory M. Swingen, PhD University of Minnesota, Department of Medicine, MMC 508,

420 Delaware St. SE, Minneapolis, MN 55455, USA, swing001@umn.edu

Michael Ujhelyi, PharmD, FCCP Medtronic, Inc., 7000 Central Ave., MS CW330,

Minneapolis, MN 55432, USA, michael.ujhelyi@medtronic.com

Sarah A. Vieau, MS Medtronic, Inc., 8200 Coral Sea St. NE, MVS41, Mounds View,

MN 55112, USA, sarah.a.vieau@medtronic.com

Anthony J. Weinhaus, PhD University of Minnesota, Department of Integrative Biology

and Physiology, 6-130 Jackson Hall, 321 Church St. SE, Minneapolis, MN 55455, USA,

weinh001@umn.edu

Robert F. Wilson, MD University of Minnesota, Department of Medicine, MMC 508,

420 Delaware St. SE, Minneapolis, MN 55455, USA, wilso008@umn.edu

Yong-Fu Xiao, MD, PhD Medtronic, Inc., 8200 Coral Sea St. NE, MVN42, Mounds

View, MN 55112, USA, yong-fu.xiao@medtronic.com

Jianyi Zhang, MD, PhD University of Minnesota, Department of Medicine, 268 Variety

Club Research Center, 401 East River Rd., Minneapolis, MN 55455, USA,

zhang047@umn.edu

xvi Contributors