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Amaurosis fugax, or "fleeting blindness," has been known as a clinical entity for hundreds of years (1). Since 1859, we also have understood that the phenomenon frequently is related to atheroembolic disease and that it is considered a classic manifestation of ocular transient ischemic attacks and a potential precursor to stroke. However, many questions about this syndrome have remained unanswered until quite recently, when a great deal of new information and thought has been directed to the subject. Transient monocular blindness (TMB) is only one manifestation of a complicated syndrome of ocular, systemic, and cerebral diseases that may include some degree of monocular blindness. The duration of blindness varies from very brief (seconds) to complete and permanent. The per manent type is referred to as ocular infarction or ocular stroke. Retinal infarction is the most severe degree of monocular blindness and usually is due to embolic occlusion of the central retinal artery or one of its branches. Varying types of arterial emboli have been described, including thrombus, cholesterol, platelets, and fibrin.
Here, two of the foremost cardiothoracic surgeons have brought together many of the top cardiologists and haematologists to produce the most current reference source on all aspects of blood conservation, from an overall clinical approach to the use of erythropoietin and the benefits of post-operative blood salvage. The subject matter covers numerous areas involved in the preoperative considerations in cardiac surgery, the intraoperative decision-making in cardiac surgery, postoperative bleeding and management and a section on the algorithm for bloodless surgery used at the New York Hospital-Cornell Medical Center.
Based on the research and clinical work presented at the Sixth International Symposium, Vascular Surgery 1992, this book gathers contributors from renowned clinicians and researchers and outstanding young investigators from around the world.
A detailed look behind the scenes at the practices and history of the thoracic surgeons of Bogota, Colombia. This book is an in-depth look at the thoracic surgeons profiled as part of Bogota A Hidden Gem guide to Surgical Tourism. As my research led me deeper into the depths of the subculture and of thoracic surgery specialty, I realized that the stories of Bogota's thoracic surgeons needed to be told, separate and distinct from the distractions of a larger book. This is not simply a directory of thoracic surgeons, but a glimpse into their lives from a sociological perspective. I have included information collected as part of the larger effort because surgery, and the role of thoracic surgeon is an intrinsic part of who they are.
Landmarks are preferred image features for a variety of computer vision tasks such as image mensuration, registration, camera calibration, motion analysis, 3D scene reconstruction, and object recognition. Main advantages of using landmarks are robustness w. r. t. lightning conditions and other radiometric vari ations as well as the ability to cope with large displacements in registration or motion analysis tasks. Also, landmark-based approaches are in general com putationally efficient, particularly when using point landmarks. Note, that the term landmark comprises both artificial and natural landmarks. Examples are comers or other characteristic points in video images, ground control points in aerial images, anatomical landmarks in medical images, prominent facial points used for biometric verification, markers at human joints used for motion capture in virtual reality applications, or in- and outdoor landmarks used for autonomous navigation of robots. This book covers the extraction oflandmarks from images as well as the use of these features for elastic image registration. Our emphasis is onmodel-based approaches, i. e. on the use of explicitly represented knowledge in image analy sis. We principally distinguish between geometric models describing the shape of objects (typically their contours) and intensity models, which directly repre sent the image intensities, i. e., the appearance of objects. Based on these classes of models we develop algorithms and methods for analyzing multimodality im ages such as traditional 20 video images or 3D medical tomographic images."
Pediatric cardiology is celebrating in the 1990s the 50th anniversary of the beginnings of the age of therapy. This informal `history' describes how the discipline grew from the era of pathologic anatomy to the dawn of therapy, the beginnings of closed heart surgery between 1939 and 1945. That dawn ushered in a remarkable half century of change and growth, leading from clinicophysiologic correlations through the start of open heart surgery in the 1950s. The text celebrates some of the achievements of this vivid and heroic age, and describes how, in the mid 1970s, new surgical and medical approaches, including prostaglandins and Doppler echocardiography, led to successful cardiac treatment in infancy, the `infant era'. Interventional cardiology and the study of childhood arrhythmias began. Now, in the 1990s, a new era emphasising molecular biology and cardiac development is growing from the tools and concepts of the past. The four eras have focused on pathologic anatomy, clinicophysiologic correlations and surgery, heart problems in infancy, and now the developing heart. In each era there have been advances in the four domains of pediatric cardiology, the heart before birth, the normal heart, heart disease and defects, and preventive cardiology. Growth in knowledge has been both episodic and dramatic, yet not a picture of unalloyed achievement. The later chapters discuss some of the problems beginning to be recognised in the new and current `developmental era'. The pioneers of pediatric cardiology, both men and women, are more than eponyms, for each used in new and original ways the tools and concepts available in their era. The interaction of tools and concepts is a theme in this book. Just as the tool of the stethoscope was vital in delineating the clinical profile of ventricular septal defect and patent ductus, the fluoroscope played a role in developing the concept of the Blalock Taussig shunt. Pioneers also include patients and their families, and the book includes some discussion of what little is known of childhood and of the child with heart disease in the four different eras. This is a brief overview of the growth of knowledge of children's hearts from before William Harvey until our own time, and includes references to histories of cardiac surgery and to collections of classic cardiac papers. By its emphasis on the child as the central historic figure, and on the interaction of tools and concepts in the growth of knowledge, the text provides a celebratory approach to the 50th anniversary of modern pediatric cardiology.
This brilliant and highly practical book provides a case-based introduction and primer to the practice of ICD therapy. It contains a huge number of images and includes real-world patient histories. The reader is able to gain extensive practical knowledge of the practice of ICD therapy with the use of these case reports. These concentrate on the skills necessary to increase specialist knowledge of defibrillator therapy practice.
This comprehensve review of scientific research supporting evidence of the relationship between cardiac disease and psychological condition offers practical suggestions for developing a clinical practice, and proposes directions for future research in the new field of "cardiac psychology." Every chapter is written by world-renowned researchers in the field. A theoretical and practical guide, it will interest physicians, clinical and health psychologists, and all professionals who seek to understand the mind-health link.
Surgical Management of Heart Failure brings together the current knowledge on the surgical management of heart failure into one volume. It is designed to have copious illustrations and photographic material that will explain the techniques and surgical management of patients with heart failure in an effective modern format.
This text covers new innovations and concepts in pediatric thoracic surgery practice, basic science and evidence, and the technical aspects of common and rare operative procedures.
It is essential for pediatric surgical trainees and consultants with interest in pediatric thoracic surgery. Providing comprehensive coverage of newer developments, it is also a useful reference work for pediatric and thoracic surgeons and a valuable guide for surgeons (adult or pediatric) managing pediatric thoracic surgery on occasional basis or only during acute emergency.Covering the subjects within pediatric thoracic surgery (non-cardiac) in significant depth, this book acts as a reference text for consultants undertaking pediatric thoracic work as well as for pediatric respiratory, anesthetists and fetal medicine doctors. Topics within this book will also be of interest to pediatric respiratory physicians and pediatric oncologists.
This thorough revision of Color Atlas of Congenital Heart Surgery features 700 vividly reproduced intraoperative images taken with a special side-mounted flash. They convey exquisite perception of depth in the operative field in full color. The atlas presents surgical techniques for the full spectrum of cardiac congenital anomalies. This includes revised and updated text on many topics such as repair of straddling tricuspid valve associated with the posterior ventricular septal defect. Throughout the text, the carefully labeled photographs provide vivid representation of three-dimensional spatial relations of congenital anomalies and surgical anatomy.
Although the disease is not very often, every otorhinolaryngologist will experience some patients suffering from vocal fold paralysis.
This is the first and unique book solely devoted to this topic.
Offers step-by-step descriptions and evaluations of the materials and/or methods of well-established techniques and new therapeutic options and approaches.
Written by leading experts: Blitzer is speaker of the American Academy of Otorhinolaryngology and Head and Neck Surgery (AAO-HNS); Sulica, also a speaker of the AAO-HNS, works in his department.
Vocal Fold Paralysis is a clinically useful reference for evaluation and treatment, as well as a summary of current knowledge and investigational approaches.
True Atlas, brilliantly illustrated.
Succint review of surgical techniques, including minimally invasive approaches for GERD.
Step by Step descriptions of 13 operative procedures in esophageal surgery.
Significantly lower priced than it's competitors.
Educed from Chassin's Operative Strategies in General Surgery, bound to be a classic.
While a surgeon many decades agotreated diseases from headtotoe, this concept has evolved, and today some degree of specialization is the rule worldwide. In many countries various boards for sub-specializations are designed, and after a broad training in general surgery, many young surgeons move on further into a specific field. Knowledge of anatomy and precise surgical technique remain the foundation of high quality surgery. A knowledgeable surgeon, equipped with excellent theore- cal and clinical skills, will only be accomplished when he or she masters the - erative techniques of the practice of surgery. The legacy of an academic surgeon or a surgical teacher relies in great part onthe transmission of his or her surgical abilities. Significant influence on the development in esophageal surgery arises from the surgical understanding of the anatomical and functional structures of the esophagus as well as the ongoing developments in the multidisciplinary m- agement in this challenging field of surgery. In bringing forth this atlas, we were motivated by the desire to create a comp- hensive and educational atlas on esophageal diseases, emphasizing all details of pathophysiologies, diagnostic strategies, pre- and postoperative management, and operative techniques covering minimally invasive and open procedures ranging fromstraightforward tomore complex procedures.
The rapid technical improvement of the extracorporeal circulation in the past decades has led to safer, more comfortable and more compatible operations in cardiac surgery and interventions which used to be an adventure are now routine practice. Although most technical variables can easily be accommo dated today, the physical influence of artificial circulation systems on blood and tissue still remains uncertain in many cases. One of our main observations in the use of the extracorporeal circulation is that the prolonged interaction with unphysiological surfaces and forces of ten releases a cascade of blood and tissue reactions, resulting in a complex type of "disease." Thus, the symptoms can range from unspecific pulmonary inflammations to a severe renal failure or from coagulation problems to a heavy cerebrovascular stroke. Based on these facts, an interdisciplinary workshop named "Current Per spectives of the Extracorporeal Circulation" took place in Duisburg, Ger many on March 26, 1999. The rationale behind the word "interdisciplinary" was to make a step for ward to establish a joint field of knowledge which would be capable of link ing the experiences and transfer the know-how of various specialists like car diac surgeons, neurologists, physiologists or the healthcare industry with their contributions to this essential topic from different perspectives."
The second half of the twentieth century saw vascu- agree or disagree, but will be stimulated to question lar surgery develop from a necessity for hemostasis their surgical management and explore possible - to a mature reconstructive art. However, this was ac- ternatives. companied by increasing patient expectations and The only certainty of the future is that it will bring the introduction of the alternative techniques of dila- change. An essential requirement for facing that tation and stenting. These factors have helped sur- change is multidisciplinary teamwork, and within geons to focus attention on the need for clinical audit that framework to define the roles of endovascular and to define clearly the limitations and standards of and invasive procedures, as well as the place of m- excellence that should be achieved in the specialty. ical management in the prevention and modification Vascular disease remains an extensive problem in of vascular disease.
This book presents the percutaneous techniques and technologies most frequently employed in structural interventional cardiology, focusing especially on how to optimize outcomes and minimize risk. Interventional procedures for aortic stenosis, mitral regurgitation, left atrial appendage closure, patent foramen ovale closure, and closure of interatrial and interventricular defects are clearly presented step by step with the aid of a wealth of images. These descriptions are complemented by a case-based analysis of the various structural pathologies and their complications. Clear guidance is also provided on patient selection, preoperative evaluation, and choice of available devices. The authors are all acknowledged experts with extensive experience in laboratories and surgical units. The book fully reflects the rapid changes in structural interventional cardiology that have occurred during recent years. These advances are in particular due to the introduction of transcatheter aortic valve implantation, which allows cardiac surgeons to achieve excellent outcomes in patients at high surgical risk. Other exciting developments include new technologies that permit better treatment of other structural cardiac pathologies and valid alternatives to medical therapy in particular patient groups.
Take your surgical skills to the next level with Cardiac Surgery , a volume in the Master Techniques in Surgery series! This outstanding resource distills vast stores of knowledge from the field's most renowned surgeons into one definitive atlas. Richly illustrated, step-by-step guidance covers a full range of adult cardiac surgical techniques, and clearly demonstrates how to avoid and manage complications and achieve optimal outcomes. Key Features Easy-to-follow guidance on the full range of adult cardiac procedures, including primary aortic valve surgery, tricuspid valve procedures, cardiovascular trauma, myocardial revascularization procedures, pericardial surgery, cardiothoracic transplantation, cardiac assist devices, and many more. Formatted chapters briefly cover indications, contraindications, and preoperative planning before fully explaining and illustrating the procedure in step-by-step detail. Outcomes, complications, avoidance of pitfalls, and follow-up are also discussed. Color illustrations visually describe each surgical technique and highlight key anatomic structures. Expertly written by international authorities, with clear demonstration of their preferred techniques. Ideal for cardiothoracic surgeons at all levels , residents and fellows, and for use with patients who ask for more detail about a particular procedure. Now with the print edition, enjoy the bundled interactive eBook edition, which can be downloaded to your tablet and smartphone or accessed online and includes features like: Complete content with enhanced navigation Powerful search tools and smart navigation cross-links that pull results from content in the book, your notes, and even the web Cross-linked pages, references, and more for easy navigation Highlighting tool for easier reference of key content throughout the text Ability to take and share notes with friends and colleagues Quick reference tabbing to save your favorite content for future use
Die Herztransplantation hat sich in den vergangenen Jahren zur Behandlung der Wahl fA1/4r Patienten im Endstadium einer Herzerkrankung entwickelt. Die beeindruckenden Ergebnisse fuAen auf Verbesserungen im Bereich der prAoperativen Evaluation, der chirurgischen Behandlung, der immunsuppressiven Therapie und des Managements der postoperativen Infektionen.
Die 3. Auflage des a žLeitfaden Herztransplantation" trAgt einer verAnderten klinischen Situation Rechnung. Die etablierten mechanischen Kreislaufsysteme dienen zur zeitlichen AoeberbrA1/4ckung bis zur Transplantation; jedoch mA1/4ssen immer noch Risiken wie hAmorrhagische und trombembolische Komplikationen sowie Infektionen bewAltigt werden. Durch das erweiterte Spektrum der Immunsuppressiva kann inzwischen fA1/4r jeden Patienten ein maAgeschneidertes Therapiekonzept angeboten werden.
Das Buch gibt eine Aoebersicht A1/4ber verschiedenste Aspekte der Herztransplantation und dient allen Berufsgruppen, die in die Transplantationsmedizin eingebunden sind, als bewAhrter Leitfaden in Ausbildung und beruflicher Praxis.
Advanced ischemic heart disease is fast becoming one of the most challenging problems facing the modern cardiovascular physician and current established therapies often fail to adequately address this population of patients. As therapy of heart disease evolves, we need to address the challenging questions posed by this clinical problem. Treatment of Advanced Ischemic Heart Disease brings together the most recent advances in surgical techniques, protection of the heart and postoperative care, to aid the study and treatment of these patients who deserve the best that modern medicine can provide them.
The diagnosis and treatment of coronary artery disease and heart failure has now been standardized to the point that there are very well established guidelines promoted by the American Heart Association and The American College of Cardiology. This text will pick up where the guidelines leave off and address the real challenge of patients with advanced ischemic heart disease. Though therapy is clearly challenging, new advances are making effective therapy of these patients truly possible. This text embodies that notion. Finally, there is much still to learn about the basic mechanisms of the progression of heart failure due to coronary artery disease and how best to assess these therapeutic options. The text will address these with a focus on treatment so that it may be a practical reference for the practicing clinician as well as the basic or clinical researcher and student.
This book provides a comprehensive, up-to-date summary of drug-coated balloon (DCB) technology and the role of DCBs in the treatment of coronary and peripheral arterial disease. In addition to clear explanation of how DCBs works, readers will find an enlightening analysis of the mistakes and successes of the past decade and the emergence of the latest delivery systems, which combine a more deliverable device with much improved drug delivery to the vessel wall. The full range of current applications of DCBs are reviewed in detail, drawing on the latest scientific evidence. Due attention is paid to newer devices, with provision of technical insights and documentation of the available clinical data. Ongoing research projects, remaining technical challenges, likely future directions, and reimbursement issues are also carefully considered. This book will be a useful tool for any interventional cardiologist, interventional radiologist, or vascular surgeon who wishes to acquire a deep knowledge of this technology and its application in both coronary and peripheral interventions.
Cryopreserved allograft tissues are now standard materials for the reconstructive cardiac surgeon. Since publication of the first edition ("Cardiac Reconstructions with Allograft Valves") in 1989, the field has progressed dramatically with increased clinical use of cardiovascular allograft tissues, with the development of new surgical techniques, and with advances in the understanding of the fundamentals of valve transplantation biology and cryopreservation. As a result, over two-thirds of the present volume represents new material. Fifty-six authors bring their expertise to thirteen comprehensive, lavishly illustrated sections which discuss the principles of the use of homograft valves, major clinical series of homograft valves for both left and right ventricular outflow tracts, cryopreserved allograft tissue for cardiac reconstruction, cell biology of heart valve leaflets, cryobiology of heart valve preservation, morphological, biochemical, and explant pathology studies of allograft heart valves, allograft valve banking, as well as detailed explanation of surgical techniques for valve and root methods for left and right ventricular outflow tract reconstructions, the Ross operation and variants, and complex reconstructions. A final section presents potential future directions for the field. Over 400 illustrations, created expressly for this book, depict the surgical techniques from the perspective of the surgeon standing at the operating table. All surgeons performing pediatric and/or adult valve replacements and reconstructive cardiac surgeries will benefit from the described methods. Cardiothoracic residents and cardiologists will also find the text useful. It will provide the surgeon with an enhanced understanding of the biological and material properties of allografts and increased familiarity with the range of surgical techniques applicable for the use of these valves, particularly in the successful management of challenging cardiac reconstructions.>
Transmediastinal gunshot injuries present the risk of immediately life threatening injuries. Stable patients have been evaluated by a combination of esophageal swallow and endoscopy, aortography and bronchoscopy. There is an increasing trend favoring CT scan. Unstable patients require immediate exploration, being prepared to enter both hemi-thoraces. Selected References: * Bergsland J, Karamanoukian HL, Soltoski PR, Salerno TA. Single suture forcircumflex exposure in coronary artery bypass grafting. Ann Thorac Surg.1999;68: 1428-1430. * Fedalen PA, Bard MR, Piacentino V, et al. Intraluminal shunt placement and off- pump coronary revascularization for coronary artery stab wound. J Trauma 200 1;50: 133-135 * Hanpeter DE, Demetriades D, Asensio JA, Berne TV, Velmahos G, Murraygunshot wounds. J Trauma 2000;49(4):689-695. * MacPherson D. Bullet Penetration: Modeling the dynamics and the incapacitation resulting from wound trauma. Ballistics Publications, EI Segundo, CA, 1994 * Wall MJ, Soltero E. Damage control for thoracic injuries, Surg Clin North AmI997;77(4):863-878. * Rozycki GS, Feliciano DV, Oschner MG, Knudson MM, Hoyt DB, Davis F, Hammerman D, Figueredo V, Harviel JD, Han DC, Schmidt JA. The role ofUltrasound in patients with possible penetrating cardiac wounds: aProspective multicenter study. J Trauma 1999; 46(4):543-552. * Roussseau H, Soula P, Bui B, D'Othee BJ, Massabuau P, Meites G, Concina P,Mazzerolles M, Joffre F, Otal P. Delayed treatment of traumatic ruptureof the thoracic aorta with endoluminal covered stent. Circulation 1999 Feb2; 99(4): 498-504.
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.
ICD therapy has become the standard form of treatment for ventricular tachyarrhythmias. With clinical data showing its efficacy in both secondary and primary prevention of premature sudden death, its use is likely to increase dramatically in the next decade. Technological advancement has been instrumental in simplifying ICD implantation. However, technical additions to the device have also made its scope of functions more complex. In addition to providing rapid and effective therapy for ventricular tachycardia and fibrillation, the ICD is now capable of providing a full spectrum dual-chamber pacing as well as therapies for atrial fibrillation. Soon, it will also be able to provide treatment for congestive heart failure using multi-site ventricular pacing and provide continuous hemodynamic monitoring. This book serves as an introductory text to those who are relatively new to this technology. In its manual form, it outlines the pertinent components of ICD functions and the basic differences among the various models. It provides practical points in ICD implantation, and in its programming and trouble-shooting.
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