The heart is our most important - and perhaps most mysterious - organ.

Every day it pumps 9000 litres of blood and beats around 100,000 times. But the heart is more than just a pump. In all major human cultures, it is seen as the source of love, sympathy, joy, courage, strength and wisdom. Why is this so?

Having witnessed the extraordinary complexity and unpredictability of human hearts in the operating theatre - each one individual in its make-up, like a fingerprint - heart surgeon Reinhard Friedl went on a search for answers. He examined closely the latest findings in neurocardiology and psychocardiology, and in The Beat of Life he shares his discoveries, using riveting personal stories to illustrate the complex relationship between the heart, the brain and the psyche.

Mechanical cardiovascular assist devices must be properly designed to avoid damage to the blood they contact. The factors that affect the hemocompatibility of a cardiovascular assist device include three major non-physiological components - the material, fluid flow paths, and flow related stresses, - as well as the device interaction with the native vasculature. Furthermore, the interaction of the device with the blood is not static. Foreign surfaces activate blood components including platelets, leukocytes and the coagulation cascade. Thrombus formation on the surface of the device can alter the fluid dynamics in a manner that causes erythrocyte damage ranging from significant hemolysis to sub-lethal trauma that can take many days to weeks to develop into a significant clinical problem. This sub-lethal blood trauma is not easily detectable without special equipment, which is typically unavailable in routine clinical practice. Surveillance for blood damage is often sub-optimal in the clinical setting, but once clinically relevant hemolysis occurs, crucial decisions - device removal, replacement, or additional medical therapies including surgery or plasmapheresis - that take into account the risk/benefit of intervention must be quickly evaluated. The various preclinical designs and testing, surgical considerations, available surveillance techniques, and clinical consequences will be discussed using recent and historical case reports to highlight key points.

SHORTLISTED FOR THE COSTA BIOGRAPHY PRIZE THE SUNDAY TIMES NO.2 BESTSELLER WINNER OF THE BMA PRESIDENT'S AWARD 2017 An incredible memoir from one of the world's most eminent heart surgeons, recalling some of the most remarkable and poignant cases he's worked on. Grim Reaper sits on the heart surgeon's shoulder. A slip of the hand and life ebbs away. The balance between life and death is so delicate, and the heart surgeon walks that rope between the two. In the operating room there is no time for doubt. It is flesh, blood, rib-retractors and pumping the vital organ with your bare hand to squeeze the life back into it. An off-day can have dire consequences - this job has a steep learning curve, and the cost is measured in human life. Cardiac surgery is not for the faint of heart. Professor Stephen Westaby took chances and pushed the boundaries of heart surgery. He saved hundreds of lives over the course of a thirty-five year career and now, in his astounding memoir, Westaby details some of his most remarkable and poignant cases - such as the baby who had suffered multiple heart attacks by six months old, a woman who lived the nightmare of locked-in syndrome, and a man whose life was powered by a battery for eight years. A powerful, important and incredibly moving book, Fragile Lives offers an exceptional insight into the exhilarating and sometimes tragic world of heart surgery, and how it feels to hold someone's life in your hands.

Artificial hearts are seductive devices. Their promissory nature as a cure for heart failure aligned neatly with the twentieth-century American medical community's view of the body as an entity of replacement parts. In Artificial Hearts, Shelley McKellar traces the controversial history of this imperfect technology beginning in the 1950s and leading up to the present day. McKellar profiles generations of researchers and devices as she traces the heart's development and clinical use. She situates the events of Dr. Michael DeBakey and Dr. Denton Cooley's professional fall-out after the first artificial heart implant case in 1969, as well as the 1982-83 Jarvik-7 heart implant case of Barney Clark, within a larger historical trajectory. She explores how some individuals-like former US Vice President Dick Cheney-affected the public profile of this technology by choosing to be implanted with artificial hearts. Finally, she explains the varied physical experiences, both negative and positive, of numerous artificial heart recipients. McKellar argues that desirability-rather than the feasibility or practicality of artificial hearts-drove the invention of the device. Technical challenges and unsettling clinical experiences produced an ambivalence toward its continued development by many researchers, clinicians, politicians, bioethicists, and the public. But the potential and promise of the artificial heart offset this ambivalence, influencing how success was characterized and by whom. Packed with larger-than-life characters-from dedicated and ardent scientists to feuding Texas surgeons and brave patients-this book is a fascinating case study that speaks to questions of expectations, limitations, and uncertainty in a high-technology medical world.

The third edition of Cardiopulmonary Bypass offers a comprehensive, and up-to-date reference text to extracorporeal cardiopulmonary support. This book provides a clinically-focused tutorial with chapters spanning the technical aspects, patient related considerations, and human factors essential to contemporary practice of cardiopulmonary bypass. Written concisely to allow the reader to gain and apply critical knowledge to the clinical setting and featuring artwork that has been extensively updated to include numerous figures and color plates imbedded into each chapter. A remarkable collection of international experts in the fields of perfusion, anesthesiology, and cardiac surgery were recruited to co-author chapters, providing a multidisciplinary approach to case management. This completely updated edition includes expanded content on developments in minimally invasive extracorporeal circulation, anticoagulation, organ injury, and human factors. The comprehensive coverage of perfusion practice in a concise, highly illustrated format makes it the go-to, portable reference manual for perfusionists, cardiac surgeons, and anesthesiologists.

With a large volume of ultrasound images and teaching videos, Pleural Ultrasound for Clinicians: A Text and E-book is a print and interactive digital resource that provides practical guidance for all those undertaking pleural ultrasound investigations and procedures. With clear, precise instructions for clinical practice, it will help clinicians: Recognise normal anatomy as well as common pleural pathologies Perfect techniques for ultrasound-guided pleural procedures Learn how to choose the correct ultrasound equipment for their department Test their knowledge through the self-assessment and revision sections

Topics include basic considerations and techniques, venous drainage of the myocardium, structure and function of the cardiac lymphatic system, coronary sinus interventions in experimental research, and more.

The diagnosis and treatment of both congenital and acquired thoracic pathologies in children and adolescents require a high degree of specialization. This book provides practical guidelines for thoracic surgeons who operate on patients from neonatal age to adolescence and for pediatric surgeons who are challenged to treat disorders such as cystic malformations of the lung, mediastinal tumors, or chest wall deformities. The chapters, written by internationally acclaimed authors, include expert commentaries with tips and tricks for the clinical practice. Plus: QR codes for access to videos of surgical procedures.

Drs. Little and Merrill draw on their expertise in general thoracic and cardiac surgery to review tracheobronchial operations, lung volume reduction operations, lung transplantation, minimally invasive esophagectomy, pleural operations, revascularizations, myocardial operations, and aortic and great vessel operations. For each operation, leading practitioners provide specific advice on what to be aware of to prevent complications -- and how to manage them if they do occur.

Once considered an experimental therapy, lung transplantation is now regarded as a viable treatment option for selected patients with end-stage lung diseases. As more and more of these cases arise, it becomes imperative for those involved in the care of lung transplant patients to have a vast understanding of the multidiscipline process of lung transplantation. This text provides a comprehensive overview of this process covering everything from the history of the lung transplant program to the long term effects of the procedure.

A TIMES BEST BOOK OF 2019 An intimate and compelling exploration into the unique psyche of the heart surgeon, by one of the profession's most eminent figures. Although Professor Stephen Westaby was born with the necessary coordination and manual dexterity, it was a head trauma sustained during university that gifted him the qualities of an exceptional heart surgeon: qualities that are frequently associated with psychopathy. His thirty-five-year career has been characterised by fearlessness and ruthless ambition; leaving empathy at the hospital door as thousands of patients put their lives in his hands. For heart surgeons, the inevitable cost of failure is death and in The Knife's Edge, Westaby reflects on the unique mindset of those who are drawn to this exhilarating and often tragic profession. We discover the pioneers who grasped opportunities and took chances to drive innovation and save lives. Often difficult, uninhibited and fearless, theirs is a field constantly threatened by the risk of public failure. Like those before him, Westaby refuses to draw the line in his search of a lifetime solution to problems of the heart. His determination is unerring - a steadfastness underpinned by his unusual mind. But as we glimpse into the future of cardiac surgery, for all its remarkable scientific advancement, one question remains: within the confines of socialised medical healthcare systems, how can heart surgeons - individuals often hardwired with avoidance of self-doubt, a penchant for glory and a flagrant disregard for authority - truly flourish?

J. Willis Hurst, MD, a pioneer in the development of cardiology, and his colleague, Douglas C. Morris, M.D., both of Emory University, have edited this book and chose its unusual title for very specific reasons. Patients sometimes have an odd view as to anatomic landmarks that identify the location of the chest, and may assign terms other than pain to their discomfort. Hence the quotation marks around "chest pain." The arrow (-->) after "chest pain" indicates that the physician initially may not know the cause of the symptom, so a differential diagnosis must be established.

This book was written to reintroduce in the modern clinical setting the knowledge and skills needed to analyze symptoms, physical findings, and ECG and x-ray abnormalities in order to accurately diagnose more than 50 different conditions that may bring about a complaint of "chest pain." Experts in the fields of cardiology, pulmonology, dermatology, orthopedics, thoracic surgery, and psychiatry contribute a unique perspective on this common but compelling medical problem. Each chapter concentrates on one causative syndrome or malady, from its initial presentation to its etiology, to differential diagnosis and treatment, while an abundance of well-designed figures serve to illustrate the location of the "chest pain."

Any cardiologist, primary care, or emergency care physician who may encounter a patient complaining of "chest pain" will benefit from this book''s clear, concise and thorough approach to the problem.

In the last two decades, tremendous strides in the field of mechanical support have extended the lives of countless sufferers of congestive heart failure, who total close to 1% of the US population. This technology has saved the lives of patients with acute heart failure due to heart attacks, dilated cardiomyopathies and post-cardiotomy shock and sustained patients with end stage congestive heart failure until a precious donor organ has become available for transplantation. In an attempt to address the growing imbalance between demand and supply of donor hearts, and armed with great hope and excitement, investigators are now examining these devices as potential alternatives to cardiac transplantation.

This book describes in detail the historical evolution, current knowledge, and future trends in the field of mechanical circulatory support. It will be of greatest interest to cardiologists, circulatory physiologists, cardiac anaesthesiologists, critical care physicians, cardiac surgeons, and other healthcare professionals who are challenged daily with the care of patients with acute and chronic heart failure.