Heart failure occurs in almost epidemic proportions, placing a huge burden on both the healthcare system, and sufferers and their families. This can only rise over coming years as the ageing population, particularly in industrialized countries, increasingly suffers from heart failure and its related comorbidities. The care of this group of patients has evolved significantly over recent years as our knowledge and understanding of the pathophysiology of heart failure has developed. It has become evident that supportive care is integral to comprehensive heart failure care, and this book provides an evidence-based overview of heart failure aetiology, its management, and the supportive care required by patients throughout the course of their disease. Supportive Care in Heart Failure integrates the complexities of heart failure care, bridging knowledge bases from cardiology and cardiothoracic surgery, general medicine and palliative care. The book reviews essential information about epidemiology and pathophysiology of heart failure, and evidence-based medical, device, surgical and interdisciplinary management. It addresses the evaluation and management of quality of life, common symptoms and problems associated with heart failure, and the holistic approach to supportive care throughout the course of the illness through the end of life. Prognostication, communication, and ethical decision making are reviewed in detail. Heart failure has traditionally presented a challenge to physicians, as a generally progressive condition with significant symptoms, a poor quality of life, and high mortality. But by applying the principles of palliative medicine, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients.

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.

This book describes the molecular mechanisms of lung cancer development and progression that determine therapeutic interventions in the era of genomics, when the rapid evolution in lung cancer diagnosis and treatment necessitates critical review of new results to integrate advances into practice. The text opens with background and emerging information regarding the molecular biology of lung cancer pathogenesis. Updated results regarding lung cancer prevention and screening are discussed, followed by chapters on diagnostic techniques and pathological evaluation. This leads on to a detailed presentation of treatment modalities, from surgery and radiation therapy to standard chemotherapy and targeted agents. The coverage includes resistance to therapy and the emergence of immunotherapy for lung cancer; in addition, the current evidence in respect of small cell lung cancer is summarized. The book presents insights from experts across disciplines to emphasize the importance of collaborative care. Advances in our understanding of issues in geriatric oncology and palliative care complete the comprehensive discussion of lung cancer.

This book provides the medical student, the surgeon in training, and the cardiologist with the theoretical foundations and some practical aspects of open heart surgery. An attempt has been made to present the material in a clear way by simplifying various concepts and theories and by employing many schematic illustrations. To present the subject matter in perspective, some chapters include historical notes. Although the book has been primarily designed to provide the theoretical background necessary for the optimal practice of open heart surgery, it also contains basic information on most surgical procedures for ischemic heart disease, acquired valvular disease, congenital heart disease, and various aspects of pre- and post-operative management.

Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" covers all stages of the diagnosis and treatment of the most common benign esophageal disorders in a concise and easy-to-read format.Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included and based both on evidence-based data and the experience of the most famous esophageal surgeons in the United States and abroad. Each chapter includes a summary of the current management strategy for the disease process, and a review of current state of the art techniques provided by world leaders on esophageal disease, surgeons and gastroenterologists alike. A special emphasis is given to emerging procedures in laparoscopy, thoracoscopy, and endoscopy. Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" is illustrated throughout with line diagrams that depict fundamental anatomic or technical principles and is a valuable resource for surgeons and gastroenterologists in residence and training.

Transplantation of the Heart and HeartLungs (N.E. Shumway). Physiologic Principles and Clinical Use of Hypothermia (L.K. Davis, R.F. Davis). Anesthetic Evaluation and Management in Bloodless Surgery (N.S. Faithfull). Normothermic Mycocardial Preservation, an Optimal Approach for Myocardial Protection During All Forms of OpenHeart Surgery (R.E. Engelman et al.). Pharmacologic Manipulations to Minimize Bloodloss in Cardiac Surgery (A.C. Cernaianu, A.J. DelRossi). Sutureless Intraluminal Ring Grafts for Aortic Replacement (G.M. Lemole). Immunologic Consequences of Transfusion (P.I. Tartter). Traumatic Rupture of the Thoracic Aorta (R.C. Camishion, J.B. Alexander). Cardiomyoplasty (R.C.J. Chiu). Current Status of Autotransfusion (R.A. Vertrees, A.C. Cernaianu). Transesophageal Echocardiology (W.H. O'Connor). The Use of Circulatory Support in Cardiac Surgery (R.L. Kormos). 9 additional articles. Index.

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.

There are growing questions regarding the safety, quality, risk management, and costs of PCC teams, their training and preparedness, and their implications on the welfare of patients and families. This innovative book, authored by an international authorship, will highlight the best practices in improving survival while paving a roadmap for the expected changes in the next 10 years as healthcare undergoes major transformation and reform. An invited group of experts in the field will participate in this project to provide the timeliest and informative approaches to how to deal with this global health challenge. The book will be indispensable to all who treat pediatric cardiac disease and will provide important information about managing the risk of patients with pediatric and congenital cardiac disease in the three domains of: the analysis of outcomes, the improvement of quality, and the safety of patients.

With the growing age of the population, the proportion of elderly patients with diffuse coronary artery disease and severe comorbidities is increasing. The characteristics of these patients render them unsuitable for currently recognized revascularization procedures (CABG, PTCA). Therefore, there is an urgent need for new treatment modalities which could alleviate their symptoms and increase blood flow to the ischemic myocardium, while being less invasive for their fragile condition. The aim of this book is to provide an anatomical and physiological background as well as a complete review of the alternative methods of revascularization which are under development, namely transmyocardial laser revascularization, therapeutic angiogenesis and neurostimulation.

This book focuses on how ventricular assist devices (VADs) can help provide destination therapy for patients with terminal heart failure, one of the most serious diseases in the world today because of the tremendous number of patients, the high mortality rate, and the cost of care. One means of providing cardiological support for patients suffering from heart failure is with VADs, and more than 10,000 patients worldwide have now been implanted with these devices. Half of them already have lived more than one year, and 2,000 patients more than two years, after surgery. This improved survival means that we have reached a point where VADs can be used for destination therapy, not just for bridge-to-recovery or bridge-to-transplant. In view of the increasing number of patients with advanced-stage heart failure and the availability and longevity of transplanted hearts, VADs can solve many problems. In addition to providing information about the devices themselves, this book includes vital guidelines on long-term management and support of VAD-implanted patients' everyday lives.

This book will provide both an evidence base and practical recommendations for the treatment of patients with congenital heart disease. It will be a resource to all health care providers, including pediatric cardiologists, pediatric intensivists, pediatric heart surgeons, fetal specialists, maternal fetal medicine specialists, neonatologists, nurses, advanced practice nurses, in addition to trainees in the field. It will summarize world knowledge on the topic of heart failure in patients with congenital heart disease. It will provide an in depth analysis of the current methods of diagnosis and treatment of heart failure. Now that surgical results are at record success rates, more patients with congenital heart disease are surviving, and thus at risk for sequelae from their disease, including heart failure. It will provide evidence based and practical recommendations to the practitioner for the management of heart failure signs and symptoms.

New Techniques for Thoracic Outlet Syndromes presents in a comprehensive format an up-to-date, state of the art reference that physicians can use in consultation to properly treat patients using the resources that modern medicine offers. This book offers the newer surgical approaches that have been developed during the past 30 years. Some of these techniques are modification of operations that were proposed previously but were not fully affective and left many patients suffering with permanent disability. This textbook is a compendium of the proper management of these patients that cannot be found in isolated reports of literature. The neurogenic-arterial thoracic outlet syndrome section covers how to diagnosis the illness using the proper tests, therefore eliminating the use of expensive, uncomfortable and inconvenient tests. The text is organized in three basic sections that cover all the aspects of the thoracic outlet syndromes. The first section addresses the neurogenic-arterial type, with the pertinent subsections: symptoms, diagnosis. A list of the useful tests is provided to make a correct diagnosis of this syndrome. This is followed by the sections on treatment, using the surgical approaches with historical aspects and evolution of the operations proposed. The second section involves the venous thoracic outlet syndrome divided into the corresponding subsections comprising: symptoms and physical findings, etiology, diagnosis. This section also includes a list of the usual tests to make the proper diagnosis. The last section of this text is dedicated to the presence of cervical ribs and their classification of the different types that occur, and also the proper surgical treatment when fusion of the upper ribs is present. New Techniques for Thoracic Outlet Syndromes offers the current, acceptable and most effective methods to handle thoracic outlet syndromes. It will be of great value to thoracic surgeons, vascular surgeons, interventional radiologists as well as fellows and residents in training for cardiothoracic and vascular surgery.

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, and one of the first to be successfully repaired by congenital heart surgeons. Although "fixed", patients born with tetralogy of Fallot cannot be considered "cured". Improving survival and quality of life for this ever-increasing adult population will continue to challenge the current and future generations of cardiologists. Adult patients with tetralogy of Fallot should be seen by a cardiologist specializing in the care of adults with congenital heart disease, to be monitored for late complications. They need to be checked regularly for any subsequent complications or disturbances of heart rhythm. This monograph is intended as both an introduction to the subject and a timely, comprehensive review, and will be welcomed by adult cardiologists, pediatric cardiologists, internists, surgeons, obstetricians, and intensivists who wish to learn about the most recent discoveries and advances concerning tetralogy of Fallot in adults. It will also be of interest to advanced undergraduates wanting to learn more about the subject.

This book represents the first comprehensive textbook devoted to the standard of care, current guidelines and innovations in the field of mesenteric vascular disease. The book reviews imaging modalities, diagnostic work up, physiologic tests, traditional open surgical techniques and novel endovascular approaches. Technical aspects of both open surgical and endovascular techniques are provided by experts in the field, with illustrations and photographs of key steps for each type of procedure. Results of epidemiologic studies and national databases are summarized, as well as large institutional experiences. An evidence-based approach is used for recommendations regarding best therapies. Diagnostic approaches including imaging and novel physiologic tests, including gastric tonometry and oxygen light spectroscopy are covered. Mesenteric Vascular Disease: Current Therapy will serve as a very useful resource for clinicians, surgeons, interventionalists, gastroenterologists and researchers dealing with and interested in mesenteric vascular diseases.

Therapeutic hypothermia has emerged as a very important treatment option for patients with cardiac arrest as it provides significant protection from developing neurologic injury once the patient has been successfully resuscitated. Studies have demonstrated over 15% absolute risk reduction in death and neurologic injury using this therapy. Although hospitals and medical centers have become familiar with this important intervention it still remains greatly under utilized due to an experience and lack of resources to safely and effectively deploy such a program. The objective of this book is to educate and familiarize both providers and institutions as to how to develop and deploy and provide therapeutic hypothermia to their patients. The current knowledge for this is provided by speakers and national experts and also by literature review. There are several courses being provided on this as well throughout the US. These are good venues for people to come and see and get hands on experience, but there still needs to be a concrete book with references on how to go about getting this program started.

Cardiopulmonary Bypass: Advancements in Extracorporeal Life Support provides comprehensive coverage on the technological developments and clinical applications of extracorporeal technologies, including the underlying basic science and the latest clinical advances in the field. Written by experts around the world, this book comprises all characteristics of cardiopulmonary bypass as well as chapters regarding equipment, physiology and pathology, pediatric aspects and clinical applications. Important highlights include the latest updates regarding minimal invasive cardiopulmonary bypass (MICPB), extracorporeal circulatory and respiratory support (ECCRS) in cardiac and non-cardiac patients, ECMO support in COVID-19, and updated guidelines of extracorporeal technologies. This book is an invaluable resource to clinicians, researchers and medical students in the fields of cardiothoracic surgery, cardiac anesthesiology, intensive care, and perfusion technology.

Rotary blood pumps increasingly are being used in open heart surgery and in assisted circulation for patients with heart disease. These rotary devices include vortex (centrifugal) and axial pumps, which can be utilized in conditions where the use of conventional pulsatile pumps would entail problems of cost and size. Rapid progress is now being made in developing new devices for controlling blood flow within the heart and great vessels as well as extracorporeally for use in coronary and intensive care units and, in the future, for long-term use. This book provides information on the physiology of nonpulsatile circulation, the development of rotary pump engineering, and the clinical application of rotary blood pumps. It also presents an overview of future developments in this important field.