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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?
Use of the transcervical approach in thoracic surgery has advanced significantly during the past 60 years, owing primarily to advances in technology. Nevertheless, the possibilities of this approach have never been compiled in a systematic way. This book aims to rectify the situation by describing, in a structured way, all the thoracic procedures that can be performed using the transcervical approach. Indications and contraindications, surgical techniques, complications, and results are all covered, based on the authors experience and published reports. The contents encompass diverse surgical endoscopic procedures for diagnosis and staging, use of the transcervical approach for surgery to the thymus and mediastinum, lungs and bronchi, trachea and esophagus and miscellaneous items including the role of robotic surgery."
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.
Robotic Cardiac Surgery is a comprehensive guide to robotic/totally endoscopic cardiac surgery. The book is intended to provide in-depth information regarding the history of robotic surgical systems, their components and principles. It emphasizes patient selection, perioperative management, anesthesia considerations and management, operative techniques and management, postoperative care and results. Extensive, detailed photographs and illustrations of different kinds of robotic surgery are also included. It provides cardiac surgeons, cardiac anesthesiologists, and perfusionists with a comprehensive review of current robotic cardiac surgeries and related knowledge. Changqing Gao, MD, is a professor at the Department of Cardiovascular Surgery, PLA General Hospital, Beijing, China.
Approximately 120 different surgical procedures are used to correct congenital heart diseases, and the burden that this places on the surgeon is compounded by the exceptional complexity of the techniques and the rarity of many of the lesions. Training is problematic, not least because of legal issues, and currently available texts, drawings and images are no substitute for real `live' surgery. Against this background, the authors have set out to create an interactive multimedia manual that covers many aspects of congenital heart surgery. Each heart defect is addressed in an individual chapter, elaborating specific surgical anatomy and indication for surgery of heart defect first, followed by video clips depicting the operative approach and technique. The clips are accompanied by a clear descriptive narrative and patient history and diagnostic images are available to provide a clear backdrop to the operation. The chosen format makes this manual not only a very powerful teaching tool for practicing cardiac surgeons and surgeons in training but also a valuable source of information for related services such as pediatric and adult cardiologists, cardiac anesthesiologist, cardiac intensivists, perfusionists and medical students.
This new edition of the bestselling step-by-step introduction to cardiac pacemakers now includes additional material on CRT and an accompanying website. It retains the effective use of full-page illustrations and short explanations that gained the book such enormous popularity and now provides information on recent advances in cardiac pacing, including biventricular pacing for the treatment of heart failure.
The fifth edition of Bojar's "Manual of Perioperative Care in Adult Cardiac Surgery" remains the gold standard for management of adult patients undergoing cardiac surgery.
The easily referenced outline format allows health practitioners of all levels to understand and apply basic concepts to patient care--perfect for cardiothoracic and general surgery residents, physician assistants, nurse practitioners, cardiologists, medical students, and critical care nurses involved in the care of both routine and complex cardiac surgery patients.
This comprehensive guide features: Detailed presentation addressing all aspects of perioperative care for adult cardiac surgery patientsOutline format allowing quick access to informationChronological approach to patient care starting with diagnostic tests then covering preoperative, intraoperative, and postoperative care issuesAdditional chapters discuss bleeding, the respiratory, cardiac, and renal subsystems as well as aspects of care specific to recovery on the postoperative floorUpdated references, information on new drug indications and new evidence to support various treatment/management options.
Practical and accessible, this new edition of "Manual of
Perioperative Care in Adult Cardiac Surgery" is the essential
reference guide to cardiac surgical patient care.
Core Topics in Thoracic Surgery provides accessible and concise coverage of the topics most often encountered in thoracic surgery practice. This handbook will guide the reader through revision of the topics covered in the FRCS(CTh) examination, and also covers more specialist topics in detail. In-depth technical sections offer guidance for difficult procedures, with useful commentaries from leading surgeons. A broad range of thoracic surgery issues are examined, with the latest evidence and information relevant to the speciality presented in a clear fashion. Combining an easy-to-use revision guide for trainees and a comprehensive reference text for cardiothoracic surgeons and recently appointed consultants, this is a one-stop guide to thoracic surgery. Authored by leading experts in the field, this resource will be invaluable to cardiothoracic surgeons, respiratory physicians and specialist nurses seeking to refresh or expand their knowledge of this field.
This book explores the unique aspects involved in the management of ECMO patients such as physiopathology and indications, setting up the device, monitoring ECMO and the patient, troubleshooting, ethical aspects and rehabilitation. For the past eight years, management of acute heart failure and Acute Respiratory Distress Syndrome (ARDS) patients has been improved by the development of short-term assistance devices, with ECMO as a first line treatment. This highly informative book provides essential insights for ICU nurses at ECMO centers around the world, who face the substantial challenges involved in the management of ECMO patients. Above all, it meets their training needs with regard to bedside monitoring for these patients, which has become a major issue. The editors and most of the contributors serve at La Pitie-Salpetriere ICU, France, which, in terms of the number of admissions and major publications produced, is one of the world's leading authorities on ECMO.
Robotic surgery is currently devoid of adequate didactic material necessary to facilitate daily application in cardiothoracic surgical practice. This book represents the definitive atlas that will lead both the practicing and new cardiothoracic surgeons in these methods. It will define the operative pathway of each procedure, from beginning to end, for surgeons who wish to be a complete robotic cardiac surgeon and include hints and procedural pitfalls derived from the experiences of chapter contributors. The book will be illustrated with high quality illustrations and color photographs from surgical operations where appropriate. Leading surgeons have contributed to the book and provided sample illustrations for their respective chapters. Anesthetic and cardiopulmonary support preparation for each operation will be included and selected references will be provided to emphasize evidence-based outcomes.
The dramatic race to transplant the first human heart spanned two years, three continents and five cities against a backdrop of searing tension, scientific brilliance, ethical controversy, racial strife and emotional turmoil. It culminated in a terrifying moment in the early hours of 3 December 1967 when, in a cramped operating theatre in a Cape Town hospital, Professor Chris Barnard stared into an empty cavity from which he had just removed a heart. He knew that he had only minutes left to make history and save the life of a 55-year-old man by filling the gaping hole in his chest with a heart which had just been beating inside a 25-year-old woman. Every Second Countsis the story of this gripping race to conquer the greatest of medical challenges. It also reveals the truth about the man at the centre of it all, whose turbulent life story was just as gripping. The kind of true story that would be dismissed as far-fetched if presented as fiction, it combines an utterly compelling portrait of cutting-edge science with raw human drama, and shows how the course of medicine itself was changed for ever.
The number of ICD patients is increasing sharply, yet the number of
electrophysiologists--physicians who specialize in the electrical
system of the heart--is not increasing as dramatically. The result
of this influx is that more and more ICD patients are being treated
by physicians and staff with little or no ICD training.
There are many fine books on device-based therapy for the heart,
but most are written for the experts. Whether you read it from
cover-to-cover or use it for reference (or both), it is written
primarily with you in mind - for people who are actually involved
in the clinical care of these patients.
"The Nuts and Bolts of ICD Therapy" is specifically written for non-cardiologists. This book is written in a lively intelligent and easy to navigate style. It emphasizes real-life clinical practice and practical tips, including illustrations from actual clinical settings. Each chapter concludes with a checklist of key points from each subject ("Nuts and Bolts").
This book discusses predominantly pectus excavatum and pectus carinatum, its variation and the treatment modalities available, including minimally invasive surgery. This will help to increase awareness of the available treatment options to doctors and healthcare workers but will also help trainee cardiac and thoracic surgeons. It is also an essential reference book for those already practicing. Chest wall deformities are a common occurrence, the commonest being pectus excavatum and pectus carinatum. The treatment for these is provided by very few centers and there is a decline in expertise especially in the UK due to rationing. When patients approach their GP they are mostly turned away and asked to live with it due to a lack of awareness and treatment modalities. The Editors have extensive experience in this field and will invite authors from other specialties, i.e. chest physicians, cardiologist, pediatric surgeons, anesthesiologists, pain management team, plastic surgeons and prosthetic departments, to contribute their views and solutions to the book.
There is an increasing need for medical thoracoscopy performed by pulmonologists, which may be video assisted and has the advantage of being very cost-effective. This book is a comprehensive and up-to-date guide to thoracoscopy for pulmonologists that documents the considerable progress in endoscopic telescopes and instrumentation. Clear practical guidance is provided on technique, and diagnostic, therapeutic, and interventional applications of thoracoscopy are all carefully examined with the aid of high-quality illustrations. Although medical thoracoscopy is much less invasive than thoracotomy, complications can occur in a small number of cases; these are discussed and advice on prevention is provided. The concluding section examines the future of the field, covering developments such as mini thoracoscopy, autofluorescence thoracoscopy, and flexi-rigid thoracoscopy.
Minimal extracorporeal circulation (MECC) systems have been designed in order to reduce dramatically the side-effects of conventional extracorporeal circulation while serving as a safe perfusion technique for open heart surgery with cardiopulmonary bypass. The book aims to provide an up-to-date and comprehensive overview covering practical advice on how to use MECC systems for those new to the field as well as tips, pitfalls, results, and latest developments. It also offers a systematic review of all published studies on a variety of MECC systems. The book will enable physicians to gain a better understanding of these new systems as well as to understand the rationale for their use in cardiac surgery. MECC requires a multidisciplinary approach, and this book will serve as an essential reference for all health care professionals working in the cardiac surgical operating room, in particular cardiothoracic surgeons, anesthesiologists, and perfusionists
This book is a valuable resource on the subject of off-pump coronary artery bypass (OPCAB) surgery, which has recently been developed as a promising technique for reducing surgical damage to patients. Because of the increasing number of older patients who are candidates for a coronary artery bypass graft (CABG) operation, less-invasive surgeries are becoming a priority all over the world. Despite some challenges, such as its technical difficulties, emerging questions, and controversies involved, OPCAB surgery in CABG is now the gold standard in Japan. This book, written by OPCAB experts, examines the procedure established and its chief benefits. Its coverage ranges from a careful evaluation of the evidence for and against OPCAB surgery to preoperative and intraoperative management of patients undergoing coronary bypass surgery. It also contains a description of advanced techniques for every aspect of the procedure. The authors[share essential insights into the latest trends in cardiovascular surgery for professionals and residents, presenting detailed descriptions of the exposure of the heart, stabilization of each coronary artery target, construction of distal anastomoses, and other important factors. The book offers an invaluable reference guide for cardiac surgeons, cardiologists, anesthesiologists, and other medical staff in operating rooms around the world.
Surgical options for the treatment of degenerative, ischemic, inflammatory, and functional mitral valve diseases have expanded greatly in recent decades. Still, a dilemma exists with employing prosthetic mitral valves - in that mechanical valves exhibit good durability but require anticoagulation versus the unpredictable durability of biological valve prostheses. Over the past few years, it has become clear that reconstruction of the mitral valve with autologous tissues effectively addresses this dilemma, with no need for anticoagulation and excellent durability, combining the best qualities of both prosthetic options without the disadvantages. Moreover, newer repair strategies, such as autologous pericardial leaflet augmentation and artificial choral replacement have expanded reparative approaches into virtually all pathologies, with excellent long-term results as compared to prosthetic valve replacement. At present, mitral repair is becoming the dominant procedure for treatment of virtually all patients with mitral valve disease. This book is designed to illustrate contemporary and sometimes diverse surgical techniques for various types of mitral valve repair with contributions from many of the leaders in the field. Mitral Valve Repair and the recently published Aortic Root Surgery are book publications arising from the Berlin Heart Valve Symposium 2008 entitled " The Biological Solution". The Mitral Valve Repair session was postponed to June 2009 and was featured as the Berlin Mitral Valve Symposium at the joint meeting of the Society for Heart Valve Diseases and the Heart Valve Society of America in Berlin. The book contains a collection of proceedings on current techniques and outcomes of mitral valve repair by many of the experts in this field which provide an authoritative reference source for cardiac surgeons, family practitioners and clinicians.
Since the introduction of laser devices to the medical sciences this technology has created great interest. Specifically, the laser's unique physical properties and precise bio-tissue interactions render this versatile source of biologic energy an attractive tool for multiple therapeutic purposes in cardiovascular medicine. Over the course of the last 2 decades the utilization of laser technology has become an important component for the management of patients with complex cardiovascular diseases. During this time period, cutting edge laser technology including a variety of wave length generators, newly designed catheters, and a selection of advanced optic fibers have been introduced and applied in the cardiovascular circulation. Improved lasing techniques in the cardiac catheterization suites and operation rooms have been implemented for treatment of ischemic coronary syndromes, peripheral arterial occlusive disease and other atherosclerotic thrombotic conditions. Moreover, during this 20 year time frame, several multicenter and single center clinical studies have been published focusing on the role and utilization of lasers in coronary and peripheral revascularization. And within the rapidly expanding field of interventional cardiac electrophysiology, laser technology has recently revolutionized the management of fractured, abandoned and malfunctioning leads of cardiac pacemakers and automatic defibrillators. Consequently, replacing a notoriously cumbersome and high risk open heart surgery with safe and markedly efficient percutaneous laser based extraction. This textbook will provide the most authoritative, comprehensive and contemporary information covering technological progress, clinical experience and pertinent aspects of laser applications in cardiovascular medicine. It will be of interest to cardiologists, vascular surgeons and interventional radiologist as well as medical students, scientists, biomedical engineering students and graduates.
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?
This Atlas is illustrated with rich pictures of cardiac surgical specimens. It not only contains normal heart specimens but also dissects those specimens, taking pictures from various angles to create a three-dimensional representation. It also includes reviews of the specimens' pathological reviews. Chapter 1 through 10 introduce the normal anatomy of the cardiac chambers and surgical approaches to the heart, while chapter 11 through 28 describe 18 kinds of congenital heart defects. There are a total of over 1,000 images and illustrations in this book, which will be of great interest not only to the surgeons, but also to the cardiologists, anaesthesiologists and surgical pathologists.
This book addresses the most technically demanding but life-changing techniques in the treatment of conotruncal heart defects, as many repairs are performed on small infants. Each chapter reviews surgical anatomy (the anatomical classification that the surgeon is using), preoperative evaluation (the surgeon's check list before doing the surgery), and surgical techniques (clear drawings and videos, minimal text). It is an essential reference book for newly qualified surgeons when performing these complex cases. Conotruncal heart defects (CTHDs) are a group of complex congenital anomalies of the cardiovascular system that are a major cause of symptomatic cardiac disease at birth. They may account for up to 30% of all congenital cardiac anomalies. In many instances, patients with CTHD are symptomatic in the first days or weeks of life, with severe cyanosis or heart failure, requiring surgery in the neonatal period or in infancy. Most CHTD are today diagnosed in utero by fetal ultrasound. CHTDs are usually defined as malformations of the cardiac outflow tracts and presumably result in disturbance in the development of the cono-truncal apparatus of the embryonic heart, as well as of the primitive aortic arches. CTHDs include the following: truncus arteriosus, tetralogy of Fallot, double outlet right (or left) ventricle, transposition of the arteries, corrected transposition of the great arteries, interrupted aortic arch. The outcomes of CHTD surgery has considerably improved in the past 20 years, with quite fascinating innovations.
The objective of this Atlas is to contribute to the knowledge of morphological findings of the main cardiovascular diseases among the various specialists who deal with people affected of heart diseases: cardiologists and cardiovascular surgeons, clinical and forensic pathologists, coroners, sports medicine doctors. The interest in cardiovascular pathology, neglected for years in many countries, is increasing worldwide and we are witnessing the revitalization of a discipline, which, in collaboration with clinicians, is making great contributions to the fight against heart diseases and sudden-unexpected deaths. This atlas of cardiovascular diseases is the result of close collaboration between Spanish specialists in cardiology and in cardiovascular pathology and describes the clinical and pathologic features (gross and histopathologial) of major cardiovascular diseases in adults, especially those acquired, but also treat relevant congenital anomalies. This book contains 635 images, 78 tables and graphics distributed in 12 chapters across the spectrum of diseases that can be found in each of the structures of the cardiovascular system (aorta, pulmonary vessels, coronaries, valves, myocardium, pericardium and conduction system). The coordinated work of forensic pathologists from different cities in Spain and cardiologists (primarily from the Hospital Universitario Puerta de Hierro de Madrid) has assembled in all chapters their two worlds (forensic pathology and cardiology) to achieve a practical work with the aim to serve as a practical tool for multiple specialists.
This book is the ultimate reference on patent foramen ovale (PFO), a defect in the septum of the heart estimated to be present in more than twenty percent of the adult population and a proven cause of systemic embolism. All chapters have been written by internationally recognized experts in the field and cover PFO genetics and anatomy in addition to the effect PFO can have on various different organs and its supposed involvement in several conditions and clinical syndromes such as migraine, diving incidence, platynea orthodeoxia, economy class syndrome, sleep apnea and persistent desaturations in mild right ventricular dysfunction. As PFO anatomy varies significantly between individuals, chapters have also been included on the diagnostic tools, methods and techniques for appropriate assessment, detection and characterization of PFO. Furthermore, the multitude of available closure devices and techniques for PFO closure are discussed together with current and ongoing trial data. The book concludes with guidance and instruction on establishing a successful PFO program. Patent Foramen Ovale will be an essential text for the whole adult and pediatric interventional community, general cardiologists, internists, primary care physicians, neurologists and device companies in addition to medical students, graduate students and fellows in training.
This book is especially focused on the surgical aspect on Gender Dysphoria. Male to female surgery is widely discussed as well as the female to male conversion. Full information on hormone administration and surgical procedures are provided. Mental health issues are also described, as well as ethics, the law and psychosocial issues. The text is extensively referenced and includes numerous photos, tables and figures to clearly illustrate information. Based on collaboration between international experts in transgender health, this book is an essential guide for health care professionals, educators, students, patients and patients' families concerning the psychological, hormonal, surgical and social support of transgender individuals.
Advances in technology and human skill have made possible percutaneous catheter-based procedures for a wide spectrum of structural heart disease. A growing number of structural heart diseases that over the past two decades would have required open heart surgery can be safely treated using percutaneous catheter-based procedures.Traditionally, guidance of catheter-based procedures is done using fluoroscopy and two-dimensional transesophageal echocardiography (2D TEE). The recent introduction in the clinical practice of RT 3D TEE has overcome most of limitations of 2D TEE. The purpose of this book is to describe the use of this imaging modality in percutaneous interventional procedures underlying its growing role and acceptance among the interventional cardiologists but also emphasizing areas of weakness. Because today interventional cardiology ranges from closure of atrial and ventricular septal defects, to repair of mitral regurgitation and aortic stenosis, from the closure of left atrial appendage and prosthesis dehiscence, to the recent use in electrophysiological procedure, this book targets not only specialists in echocardiography and interventional cardiology but also general cardiologists. General cardiologists will find in any chapter anatomy of the structure treated (i.e. atrial septum, mitral valve...), a description of the morphopathology as seen with RT 3D TEE (degenerative or ischemic mitral regurgitation) the up-to-date indications to the specific percutaneous treatment and typical and unusual clinical cases.
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