This issue of Thoracic Surgery Clinics of North America, guest edited by Drs. Jean Deslauriers, Farid Shamji, and Bill Nelems, is the second of two devoted to Fundamentals of Airway Surgery. The editors have assembled expert authors to review the following topics: From Open to Bedside Percutaneous Tracheostomy; Anterior Mediastinal Tracheostomy: Past, Present, and Future; Extended Sleeve Resections; Bronchoplasties at the Segmental Level; Challenges of Carinal Resection and Reconstruction; Carinal Pneumonectomy; Management of Post-Pneumonectomy Broncho-Pleural Fistula: From Thoracoplasty to Trans-Sternal Closure; Tracheal Transplantation: State of the Art and Key Role of Blood Supply in its Success; Autologous Tracheal Replacement; Pathophysiology and Predictors of Bronchial Complications After Lung Transplantation; Management of Bronchial Complications After Lung Transplantation and Late Sequelae; Experiences with Prosthetic Airway Replacement: From the Use of Marlex Meshes to Tissue Engineering; Management of Acquired Benign Tracheo-Esophageal Fistulas; Strategies in the Treatment of Malignant Tracheoesophageal Fistulas; Recognition and Management of Life-Threatening Tracheo-Vascular Fistulae and How to Prevent Them; Principles of Urgent Management of Acute Airway Obstruction; Tracheo-Bronchial Injuries Secondary to Blunt Chest Trauma; Cricothyroid Approach for Emergency Access to the Airway; Use of Silicone Tubes in the Management of Complex Airway Problems; Management of the Airway after Tracheal Reconstruction; Importance of a Team Effort in the Success of Airway Surgery; 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.

An interdisciplinary panel of pioneers and opinion leaders review the basic, preclinical, clinical, and developmental pathways to new treatment strategies, such as therapeutic angiogenesis and myogenesis. The authors take advantage of new biological understanding, novel therapeutic targets, multiple available and well-studied therapeutic strategies, and the necessary imaging techniques to measure outcomes. Their in-depth discussions cover the identification of new therapeutic targets and pathways, the investigation of transcriptional factors, master switch molecules, cell-based approaches, chemokines, a better understanding of the effects of aging, endothelial dysfunction, and hypercholesterolemia in response to angiogenic stimuli. Highlights include examination of drug delivery problems, outcomes measure, stem therapy, high-risk interventions, development pathways, and future possibilities.

This book explores the non-interventional aspects of interventional pulmonology, focusing on diseases of the central airways. As the field of bronchology and interventional pulmonology expands, newer conditions involving the central airways are being recognized with increasing frequency. Current literature has mainly focused on technical aspects of the subspecialty, but this book illuminates what else interventional pulmonology has to offer the pulmonologist, including diagnosis and alternate therapeutic options. Diseases of the Central Airways: A Clinical Guide presents techniques for the diagnoses, management and treatment of patients with intriguing central airway conditions such as: black bronchoscopy, tracheobronchomalacia, endobronchial tuberculosis, and tracheobronchopathia osteochondroplastica. In-depth chapters are written by international experts and are up-to-date and comprehensive reviews. This important new book will contribute significantly to the welfare of patients with lung ailments of the central airways.

This issue of the Interventional Cardiology Clinics, edited by Dr. Sahil Parikh, is entitled "Coronary and Endovascular Stents" and covers a wide array of topics. Subjects covered include, but are not limited to, a historical review of stent development; the rationale for stenting; principles of stent design; the role of stent composition and surface modification; endovascular drug delivery and drug elution systems; design and clinical considerations for BRS and endovascular stent grafts; the pathology of endovascular stents, and stent failures.

This book provides an overview of the etiology of coronary artery disease and focuses on the main therapies and drug interventions currently available. It highlights drug pharmacology and therapeutic challenges, with a special emphasis on the underlying principles of available therapeutics and the on-going development of drugs for coronary artery disease. The book is divided into eight chapters, the first of which describes the classical mechanism of coronary artery disease and its clinical presentations. Chapter 2 lists the principles of and related evidence on the prevention and treatment of coronary artery disease. This includes diet and lifestyle management, and guidelines for the treatment of acute coronary syndrome and stable coronary artery disease. In turn, Chapter 3 describes revascularization treatments, covering percutaneous coronary interventions, coronary artery bypass grafts and thrombolysis. This chapter also addresses the main therapeutic challenges. The following chapters provide an overview of three major categories of coronary artery disease drugs, which target thrombosis (Chapter 4), lipid metabolism (Chapter 5), and hypertension (Chapter 6). Heart failure constitutes the major health burden in the late stage of coronary artery disease; accordingly, current heart failure therapeutics and related drug pharmacology are described in Chapter 7. In closing, Chapter 8 provides a summary of on-going clinical trials for coronary artery disease drug development and discusses a number of promising areas in which intensive research into new therapeutics is being pursued. Given its scope, the book will be of interest to clinicians, medical students and research scientists, as well as to pharmaceutical professionals who are seeking new therapies and drugs for coronary artery disease and related disorders.

Malignant mesothelioma is a rare form of cancer, in which the cancer cells are found in the sac lining the chest (pleura) or abdomen (peritoneum). This lethal disease is associated with asbestos and has vast economic and legal implications. As the disease takes approximately twenty years to manifest itself in humans, a wave of diagnoses is expected in the near future. In the United States alone, an estimated 3,500 - 4,000 patients are diagnosed with mesothelioma annually, and it is estimated that over the next 35 years, more than 250,000 people in Western Europe will be diagnosed with the disease. Malignant Mesothelioma, edited by internationally recognized experts in the field, is a comprehensive text that relates science, pathology, clinical aspects and therapy for mesothelioma under one cover. The book integrates the newest research and advances in its discussions of the disease, covering such topics as carcinogenesis, epidemiology, benchwork, endoscopy, multimodality approaches and treatment. It includes discussions on novel approaches to mesothelioma, such as gene therapy, vaccination strategies and immunotherapy, as well as discussions on the legal and economic aspects of the disease. Over 200 illustrations round out the text. An invaluable reference for the medical oncologist, thoracic surgeon, radiation oncologist, pulmonologist, and benchworker interested in the disease.

This book on cardiac extracellular matrix (ECM) features three sections, Fundamental Science, Pre-Clinical and Translational Science, and Clinical Applications. In the Fundamental Science section, we will cover the spectrum of basic ECM science from ECM's role in development, biomechanical properties, cardiac ECM influence of cardiomyocyte biology, pathophysiology of ECM in heart disease, and ECM in tissue engineering. Section two, Preclinical and Translational Science, will discuss cardiac ECM technologies in the clinical pipeline including approaches to ECM as a therapeutic, animal models of cardiac research, tracking and imaging methods of cardiac ECM, and cGMP manufacturing and regulatory considerations for ECM based therapeutics. Finally, the third section, Clinical Applications, will highlight the clinical experience around cardiac ECM including therapeutic strategies targeting scar tissue in the heart, Clinical trial design and regulatory considerations, current human clinical trials in cardiovascular medicine and the role of pharmaceutical and biotech companies in the commercialization of ECM technologies for cardiovascular indications. This book provides a comprehensive review for basic and translational researchers as well as clinical practitioners and those involved in commercialization, regulatory and entrepreneurial activities.

HE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, or T"lCD," is arguably the most technologically challenging type of therapy that physicians utilize today. At the same time, engineers who design ICDs are being called upon by clinicians to extend even further the technological envelope in quest of building the "ideal" device. To the extent, however, that physicians who utilize ICDs are not sufficiently comfortable with or familiar with the engineering principles that guide ICD function, the full clinical potential of even an ideal device will not be realized. In comple mentary fashion, engineers require as full an appreciation as possi ble of the real world "boundary conditions" and clinical impact of various ICD features, if the latter are truly to be perfected. This book is intended to serve as an educational tool to foster mutual understanding and communication among physicians, engineers, and other professionals involved in ICD therapy, with the ultimate purpose of enhancing patient care. The highly varied backgrounds of such a diverse audience posed obvious challenges in the preparation of this volume. Given the overwhelmingly greater involvement of clinicians in the day-to day management and follow-up of ICD recipients, we gave high priority to the presentation of oftentimes complex yet relevant engi neering concepts in a manner that could be understandable to most clinicians."

The two previous editions of "Applied Physiology in Intensive Care Medicine" proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use. In this second volume some of the most renowned experts in the field offer detailed reviews on measurement techniques and physiological processes of crucial importance in intensive care medicine. Throughout, a key aim is to help overcome the fundamental unevenness in clinicians understanding of applied physiology, which can lead to suboptimal treatment decisions. "Applied Physiology in Intensive Care" has been written by some of the most renowned experts in the field and provides an up-to-date compendium of practical bedside knowledge essential to the effective delivery of acute care medicine. It will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.

A panel of recognized authorities comprehensively review the medical, surgical, and pathophysiologic issues relevant to lung volume reduction surgery for emphysema. Topics range from the open technique and video-assisted thoracoscopic approaches to LVRS, to anesthetic management, to perioperative and nursing care of the patient. The experts also detail the selection of candidates for LVRS, the clinical results and clinical trials in LVRS, and the effects of LVRS on survival rates.

Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly flourished. This book presents a comprehensive overview of both pathophysiological and practical aspects of circulatory and respiratory extracorporeal support. The basics of ECMO, including its history, the "ECMO team," cannulation, materials, and blood- surface interactions, are first discussed. The various indications for and particular characteristics of circulatory and respiratory extracorporeal life support are then described in detail in the main part of the book. Patient care during ECMO and monitoring of the ECMO patient are also carefully covered, with explanation of the management of technical and clinical complications and transport-related problems. Further topics include long-term therapy options beyond ECMO, such as ventricular assist devices and transplants, outcome, the new frontiers of ECMO for organ procurement and future challenges. The authors are well-known experts in the field whose authoritative contributions and attention to practical aspects will be invaluable for novices and experienced practitioners alike.

With the introduction of cardiac surgery more than five decades ago and the use of the heart-lung machine for open heart surgical procedures granting the surgeon unlimited time in which to operate inside the heart, a complex task has been given to the Perfusionist. With a pairing of a perfusionist and a surgeon for each chapter, this book is an essential collection of techniques and protocols to aid in decision making in the operating room.

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.

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.

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.

The landscape of cardiac surgery is changing, as is the field of interventional cardiology. The idea of accessing and replacing a failing valve through the patients vasculature has become the most rapidly expanding therapy of choice in cardiovascular disease. Transcatheter Valve Therapies chronicles the astonishing advances that have taken place in the field and prepares readers for the challenging future of cardiac valve therapies. Designed to meet the growing needs of cardiologists, cardiac surgeons, anesthetists, and general practitioners, the book covers all aspects from logistic needs to clinical outcomes. It provides a comprehensive overview of transcatheter valve therapies and the necessary understanding for a successful clinical introduction at individual institutions. Topics include: Epidemiologic considerations Aspects of balloon aortic valvuloplasty as a stand-alone procedure or as part of the transcatheter valve replacement The history of how transcatheter valve therapies were implemented into surgical practice New imaging modalities The particularities of transcatheter access Aortic root anatomy Emerging technologies and future design improvements Development steps of aortic devices and potential solutions for transcatheter tricuspid, mitral, and pulmonary valve replacement The rigorous testing requirements for endovascular medical devices Clinical results of aortic transcatheter valve therapies in easy accessible text and table formats The future of transcatheter valve therapies All topics are discussed based on the author's own clinical and experimental experience in the field. This volume is essential for anyone involved in transcatheter valve implantation, clinicians wishing to become more involved in improving transcatheter valve therapies, and researchers engaged in building and creating new medical technologies to shape the cardiovascular landscape of the future.

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.

The second edition of this critical text features heavily revised chapters detailing how to approach the anesthetic and perioperative management of adult and pediatric patients with congenital heart disease. Initially, a broad overview of relevant concepts in pediatric cardiovascular embryology, physiology, and pharmacology is provided. Subsequently, relevant diagnostic approaches including the use of three-dimensional modeling in surgical planning and preoperative considerations are described. The intraoperative management of a wide range of specific lesions is discussed, with full descriptions of anesthesia plans and the appropriate diagnostic methods and surgical interventions. New topics detailed include the use of hybrid techniques and applications of electrophysiology in patients with congenital heart disease. Postoperative care and potential future approaches are also addressed. Congenital Heart Disease in Pediatric and Adult Patients: Anesthetic and Perioperative Management provide a comprehensive, up-to-date overview of the care of the pediatric patient undergoing cardiac surgery and anesthesia. It is therefore of interest to all practicing and trainee medical professionals who encounter these patients in their day-to-day practice.

Since publication of the First Edition, advances in the diagnosis and prevention and treatment strategies of the vulnerable plaque have necessitated this greatly expanded second edition. With several new chapters covering mainly diagnostic and treatment options, The Handbook of the Vulnerable Plaque will remain the benchmark text for all interventional cardiologists treating vulnerable patients by providing the physician with comprehensive insight into the world of the vulnerable plaque.

Heart transplantation remains one of the major scientific achievements of twentieth century medicine. During the past four decades, it has evolved from an unproven experimental surgical technique to the most effective form of therapy for refractory end-stage heart disease. It has captured the public's imagination and expanded our understanding of fundamental immunologic mechanisms that are responsible for cellular and humorally-mediated immunity. Despite its successes, many clinical and scientific problems remain. One or more bouts of acute cellular or humoral (vascular) rejection will occur in over 75% of transplant recipients despite current immunosuppressive strategies. Further, rejection directly results in approximately 20% of post-transplant deaths and is believed to play a major role in the development of late allograft dysfunction and coronary vasculopathy. This book by international experts in the fields of transplantation medicine, immunobiology and cardiac imaging provides the reader with an up-to-date, consise summary of the latest developments in the diagnosis and treatment of acute cardiac rejection. It is axiomatic that a more complete understanding of the pathogenic processes involved in rejection will ultimately lead to its prevention. This volume will be useful to transplant cardiologists, cardiovascular surgeons, cardiac pathologists and transplant scientists who seek to prolong the lifespan and improve the quality of life of their transplant recipients.

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.

The first in the Problems in Anesthesia seris, Cardiothoracic Surgery examine and provide guidance for a number of problematic clinical scenarios in cardiothoracic surgery anesthesia. This is a field which is growing in complexity due to the increasingly diverse set of conditions that are now treated surgically, and also due to developments in technology which are leading to different approaches to even common problems. This book will be of interest to the qualified specialist and the general trainee in anesthesiology.

Cases are presented followed by an approach to the case, utilizing the various experiences of anesthesiologists from both sides of the Atlantic. The case-based teaching relates the material to the clinic, and the discussion then explains the options in approach. Each chapter concludes with a series of essential tips in dealing with the various problems. Cases covered range from the common (e.g. off-pump coronary bypass) to the rare (e.g. anesthetic management of the patient with carcinoid heart disease).

The aim of the book is to allow readers to learn from both the successes and the complications within the cases covered, and in this way disseminate knowledge amongst those working in the field as well as pave the way for further investigation and continued advancement.

Mechanical Circulatory Support: Principles and Applications offers innovative approaches to complex clinical scenarios and represents the current state-of-the-art for managing patients on mechanical circulatory support devices. Topics are presented in a concise fashion, making it a practical resource for care givers who need a user's manual in the heat of the moment during patient care as well as a reference for a better understanding of the unique components of every device available for human use. This book provides a comprehensive, up-to-date analysis of the most relevant issues facing health care providers in the management of advanced heart failure. With content that features patient selection strategies, implantation techniques, device specific considerations, and management of clinical challenges in the post-operative setting, this textbook offers evidence-based answers to the complex questions facing nurses, perfusionists, advanced practice providers, and physicians.