Over two centuries ago, oxygen was discovered as "air vital" the component of the earth's atmosphere necessary for life. Less than five years after this discovery, it was found that oxygen was both a life-sustaining and life threatening inhalant as it plays a role in the two extremes of the animal kingdom: life and death. In the subse quent years, we have made major strides in understanding the role of oxygen in maintaining life and volumes of information are now available on this topic. Our knowledge of the contribution of oxygen in cellular dysfunction and cell death which for the most part had lagged behind has begun to catch up. The deleterious ef fects of oxygen radicals and activated oxygen species on a variety of biological systems have now been described. Recently attention has also been focused on the toxic effects of oxygen on the cardiovascular system. The major aim of the present treatise is to offer an integrated view of the pathophysiological aspects of oxygen toxicity in the heart and blood vessels coupled with a review of therapeutic approaches (hopes?) with free radical scavengers and antioxidants. Internationally known expert investigators provide a concise and critical review on the topic of their expertise which also contains data from their own research."

Through fourteen years of work as a surgeon in Erbil, Iraq, Amir Al-Dabbagh built a sense of genuine trust and friendship with his patients, the society of Erbil, his colleagues, and students in the city, a feeling that continues to inspire him to return to the city, and record his experiences in this memoir. Amir Al-Dabbagh started his medical career in 1970, graduating from Mosul and working in Iraq for six years before a period practicing medicine and surgery in the UK. After being forced into leaving Iraq in 1993, Amir continued working in the UK at Trafford General Hospital and the Manchester Royal Infirmary. His career has been one of patient care and student training, as a consultant surgeon and dean of a medical college in Erbil through peace and war. This memoir is a collection of thoughts and experiences of the medical profession through times of war and inner turmoil, fleeing as a refugee and collected wisdom on undergraduate and postgraduate training as well as good practice in patient care and surgery. The author reflects on the importance of family and friends and a genuine love of Erbil and Iraq, a beautiful country overflowing with history and welcoming people. Ultimately, nothing would have forced him to leave Erbil but the direct threat on his life. Also included is an account of Dr Waleed Khalid's practice in Baghdad, as consultant cardiothoracic and vascular surgeon during the Iraq-Iran War and the First Gulf War, providing another interesting perspective on striving to care for one's patients as a surgeon in turbulent times. Dr Waleed's perseverance to build the first cardiothoracic and vascular unit in the north of Iraq was fraught with many obstacles, which he clearly highlights in his account.

For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.

There is no standard textbook at this time on endovascular management of thoracic aortic pathologies. Atlas of Thoracic Aortic Endografting contains clinical case scenarios as well as controversies to highlight the use of this new technology. The various aortic pathologies are discussed, combining etiology, diagnostic tools like intravascular ultrasound (IVUS) and 64 slice CT scans which are all state of the art technologies, endovascular treatment, management of endoleaks, reinterventions combined with techniques of trouble shooting. This book highlights the new changes in the management of thoracic aortic diseases.

Cardiac disorders are an exciting area of classic pathology and recently defined disease. Cardiac Pathology: A Guide to Current Practice discusses the various disorders and also provides a backdrop of developmental embryology, diagnostic imaging and current therapeutics. Cardiac Pathology: A Guide to Current Practice aims to deliver in bench-book format a comprehensive overview of cardiac pathology that is relevant to those practicing in surgical pathology and autopsy arenas. Clear illustrations of the common styles of dissection are provided along with the normal anatomy and histology. Chapters cover the approach to the autopsy heart, ischemic heart disease, myocarditis, sudden death, valvular disease, transplant pathology, cardiomyopathy, cardiac neoplasia and congenital heart disease with a clear analysis of diagnostic criteria (macroscopic, microscopic and genetic) for both common cardiac diseases and those of rare format. The text is accompanied by high-quality macroscopic and microscopic images and references to other in-depth specialty data sources. Although aimed in particular at pathologists, Cardiac Pathology: A Guide to Current Practice should also be of value to cardiologists, cardiothoracic surgeons and other professions allied to medicine.

This important new book presents advancements in the treatment and prevention of Atrial Fibrillation (AF). The reader is provided with the latest information that is critically important in the daily care and for the potential cure of patients with AF. Each chapter deals with a different aspect of AF and each chapter is authored by internationally recognized experts in the evolving field of cardiac electrophysiology. This book is a single source that provides a multi-perspective look at and approach to AF. Because AF is so prevalent and affects all areas of medicine, the information in this book will be useful to all those in the medical field.

This book presents and describes a series of informative clinical cases with the aim of providing the reader with a clear understanding of the most frequent and challenging scenarios that a cardiologist may face during daily clinical practice. All major topics in modern clinical cardiology are addressed, including acute ischemic heart disease, conditions that mimic ischemic heart disease, heart failure and resynchronization therapy, cardiomyopathy, valvular heart disease, arrhythmias and channelopathies. Guidance is provided on imaging techniques and their interpretation, patient management taking into account potential comorbidities and follow-up appropriate to the clinical circumstances. The paradigmatic clinical cases in this book will serve as a sound basis for learning for medical students, residents and others wishing to meet successfully the challenges posed by cardiac disease. In addition, the book will be a very useful reference for the more experienced cardiologist.

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.

T e four heart valves reside in the center of the heart. T is indicates their crucial role in cardiac performance. Fau- less function of the valves is a prerequisite for unidir- tional forward movement of the blood, and such function is necessary to support the ef orts of the cardiac atria and ventricles. Healthy heart valves function gracefully and of er mechanical durability. Bioengineers have to marvel at the biomechanical evolution of these perfectly placed valves. Heart valves can be involved in pathological processes, however, and only then do we realize just how indispensable they really are. At one time, serious valve disorders used to be a matter of life and death for patients. Only in recent decades have surgeons been able to reverse the ominous course of heart valve disease and of er patients a quality of life and life span comparable to that of healthy persons. T e story of this ef ort began approximately 100 years ago, and today heart valve surgery is a substantial subspecialty of cardiac surgery, with accumulated experience in indications, procedures, risks, and outcomes. T e aim of this book is to present a richly illustrated compendium of the present knowledge related to heart valve surgery, based on the clinical expertise of the authors as well as the newest treatment modalities. T e authors thank Dr. Alireeza Matloobi from the Mayo Clinic for his help in preparating the book.

Introduction to CT scan and MRI.- Anomalous systemic venous connections.- Anomalous pulmonary venous connections.- Atrial septal defect.- Unroofed coronary sinus.- Atrioventricular septal defect.- Ventricular septal defect.- Tetralogy of Fallot.- Tetralogy of Fallot with absent pulmonary valve.- Pulmonary atresia with intact ventricular septum.- Ebstein's anomaly.- Patent ductus arteriosus.- Left ventricular outflow tract obstruction.- Aortic coarctation.- Aortic arch interruption.- Complete transposition of the great arteries.- Hypoplastic left heart syndrome.- Cor triatriatum.- Tricuspid atresia.- Single ventricle.- Pulmonary atresia with ventricular septal defect.- Truncus arteriosus.- Aorto-pulmonary window.- Anomalous pulmonary arteries.- Anomalous coronary arteries.- Double outlet right ventricle.- Double discordance.- Isomerism.- Slings and rings.

Imaging of the aortic root.- Perioperative imaging for assessing aortic and mitral valve diseases and surgical procedures.- Innovations in aortic valve surgery.- The aortic root.- Percutaneous transluminal aortic valve replacement: The CoreValve prosthesis.- Transapical aortic valve implantation - A truly minimally invasive option for high-risk patients.- From minimally invasive to percutaneous aortic valve replacement.- Sutureless equine aortic valve replacement.- The Ross operation: Aortic valve and root replacement with pulmonary autograft.- Pulmonary autograft or aortic allograft for surgical treatment of active infective aortic valve endocarditis: a review of the literature.- The Ross operation: two decades of clinical experience.- Aortic valve repair and valve sparing root procedures.- The bicuspid aortic valve.- From dynamic anatomy to conservative aortic valve surgery: the tale of the ring.- Yacoub/David techniques for aortic root operation: success and failures.- Aortic annuloplasty.- Correction of aortic valve incompetence combined with ascending aortic aneurysm by relocation of the aortic valve plane through a short-length aortic graft replacement.- Using BioGlue to achieve hemostasis in aortic root surgery.- Endocarditis.- Challenges in the surgical management of infective endocarditis.- Clinical results of the Shelhigh(R) stentless bioprosthesis in patients with active infective endocarditis: .- Double valve endocarditis and evolving paraannular abscess formation.- Aortic root abscess: reconstruction of the left ventricular outflow tract and allograft aortic valve and root replacement.- Implantation techniques of freehand subcoronary aortic valve and root replacement with a cryopreserved allograft for aortic root abscess.- Surgery for atrial fibrillation.- Cryoablation for the treatment of atrial fibrillation in patients undergoing minimally invasive mitral valve surgery.- Minimally invasive endoscopic ablation on the beating heart in patients with lone atrial fibrillation.- Hemodynamic evaluation of the bioprosthetic aortic valves.- Evaluation of bioprosthetic valve performance as a function of geometric orifice area and space efficiency- A reliable alternative to effective orifice area.- Long-term results of biological valves.- Stented and stentless aortic bioprostheses: competitive or complimentary?.- Edwards Prima Plus Stentless Bioprosthesis: Long-term clinical and hemodynamic results.- The Cryo-Life O'Brien stentless valve: 1991-2008.- Medtronic stentless Freestyle(R) porcine aortic valve replacement.- The ATS 3f Aortic Bioprosthesis.- The Vascutek Elan stentless porcine prosthesis - The Glasgow experience.- Sorin pericardial valves.- The changing role of pericardial tissue in biological valve surgery: 22 years' experience with the Sorin Mitroflow stented pericardial valve.- 20 years' durability of Carpentier-Edwards Perimount stented pericardial aortic valve.- Twenty-year experience with the St. Jude Medical Biocor bioprosthesis in the aortic position.- 20-Year durability of bioprostheses in the aortic position.- Clinical results including hemodynamic performance of the Medtronic Mosaic porcine bioprosthesis up to ten years.- Aortic root replacement with the BioValsalva prosthesis.- Valve replacement in renal dialysis patients: bioprostheses versus mechanical prostheses.- Replacement of bioprostheses after structural valve deterioration.- Predictors of patient's outcome.- Predicted outcomes after aortic valve replacement in octogenarians with aortic stenosis.- Predicted patient outcome after bioprosthetic AVR and the Ross operation.- Anticoagulation.- Anticoagulation and self-management of INR: mid-term results.- Tissue engineering.- Biomatrix-polymer hybrid material for heart valve tissue engineering.- Standards for the in vitro fabrication of heart valves using human umbilical cord cells.- Tissue engineering with a decellularized valve matrix.- Regularatory issues on tissue valves.- Human tissues for car

Although cardiac surgery has made an enormous progress during the last decades, the discipline has to cope with essential changes: Patients are increasingly cared for by cardiologists and therefore referred to the surgeon in a later stage of disease. Consequently, they are more often in an increasingly serious state or in advanced age with significant comorbidities. In order to meet the requirements of these different patient groups, cardiosurgical treatments require special protectional strategies for the heart in order to perform the planned operations safely. This book presents the latest knowledge of modern techniques of myocardial protection taking into consideration the different patient groups and current scientific strategies. Furthermore, it discusses present and future scientific approaches in myocardial protection and preservation.

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.

Written by internationally acclaimed specialists, Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides pertinent and concise procedure descriptions spanning benign and malignant problems and minimally invasive procedures. Complications are reviewed when appropriate for the organ system and problem, creating a book that is both comprehensive and accessible. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Forming part of the series, Surgery: Complications, Risks and Consequences, this volume Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides a valuable resource for all general surgeons and residents in training. Other healthcare providers will also find this a useful resource.

Vascular care has evolved from conservative therapy and open surgical therapy to a minimally invasive approach using endovascular techniques, laparoscopic or thoracoscopic techniques as well as hybrids of open and endovascular techniques. This volume provides up-to-the-minute information and details new developments and procedures.

The complexity of decision making in thoracic surgery is growing exponentially. As new technology is introduced, physicians from nonsurgical specialties offer alternative and competing therapies for what was once the exclusive province of the thoracic surgeon. In addition, there is increasing knowledge regarding the efficacy of traditional thoracic surgical therapies. How to select among these varied and complex approaches is becoming increasingly difficult. The first two editions of this book have found wide acceptance among practicing surgeons, trainees, and educators. Chapters from them are regularly cited by the Thoracic Surgery Directors Association as valuable resources for their weekly curriculum exercises. As in the first two editions, chapters adhere to a specific format (updated for the third edition). This approach provides uniformity to the presentations, making it possible to identify useful material at a glance.

Redo cardiac surgeries are challenging cases with a myriad of influential factors, ranging from the patient's pathology to the whimsy of the previous surgeon. Redo Cardiac Surgery in Adults, 2nd Edition clearly outlines practical approaches, surgical techniques, and management of associated conditions such as perioperative stroke and acute kidney function. It covers the spectrum of redo cardiac operations, including coronary artery bypass, mitral valve repair, reoperation for prosthetic mitral valve endocarditis, aortic arch reoperation, descending and thoracoabdominal aortic reoperation, and reoperations following endovascular aortic repair. All redo cardiac surgeries present a complex array of challenges beyond what the original procedure demands. This book, written by an outstanding group of prominent physicians, will give the reader the knowledge and tools to approach these cases with confidence.

Designed to provide a highly visual reference for surgeons and other members of the patient management team, Atlas of Intestinal Stomas is based on the 1967 gold standard text, Turnbull and Weakly's Atlas of Intestinal Stomas. Additions include chapters on anatomy and physiology, biliary stomas, pediatric ostomies, the continent ileostomy, urostomy, laparoscopic stoma construction, stomas in trauma surgery, stomas for antegrade continence enema, percutaneous ostomies, and quality of life. There are also sections on ileostomy, colostomy, enterostomal therapy and on the management of complications of stomas such as management of the high output ostomy, enterocutaneous fistula, parastomal hernia, prolapse, and skin conditions. The Cleveland Clinic pioneered the entire practice of ostomies, beginning in 1858 and continuing to this day as the world's leading academic and clinical center. The editors and contributors are all current or former Cleveland Clinic physicians and instructors. The fundamental focus of the book is not only how to install ostomies, but how to avoid complications and how to treat complications when they arise. Atlas of Intestinal Stomas will be of great value to colorectal and general surgeons, both in practice and in training.

Modern biological understanding is the basis for a multimodality treatment of a tumor. 'Anatomic Basis of Tumor Surgery' is the only book that provides an anatomic basis and description of tumor surgery based on an understanding of both the anatomy and biology of tumor progression. It presents the regional anatomy to allow tailoring of the operation as demanded.

When doctors first look at sutureless anastomosis devices created by new technologies, the most frequent comment is how amazingly easy it is to create a vascular anastomosis and, as a direct consequence, they believe anybody could play the role of the cardiovascular surgeon. Pessimistic c- diovascular surgeons, on their side, think that creating a machine capable of perfectly reproducing their core activity, which consists in making an- tomosis, will kill their profession. Actually, no medical specialty's demise has been more often predicted and, at the same time, more greatly ex- gerated than that of cardiovascular surgery. According to its detractors, - ginning in the late 1980s with the angioplasty boom, continuing in the mid-1990s with the introduction of bare metal stents, and then more - cently with the introduction of drug-eluting stents, cardiovascular surgery has been on life support for nearly 15 years. This specialty's claimed collapse has generally been attributed to recent advantages in percutaneous procedures and devices that give the oppor- nity to non-surgeon doctors to accomplish the surgeon's work. The reality is different. Data suggest that cardiac surgery continues to survive and has not suffered the precipitous decline that was predicted. From the economical standpoint, CABG is much more of a mature market and the size of the opportunity remains impressive and relatively stable, with around 1,500,000 procedures performed annually worldwide, at a total cost approaching 2. 5 billion US$.

These congenital deformities, funnel or keel chest deformities, as well as Poland syndromes, affect a small group of patients who suffer from aesthetic rather than functional impairment. The wide variety of diagnoses and recommended therapies, mostly surgical procedures, can be very confusing for patients, their parents, physicians and surgeons. In recent years several techniques have been refined and developed to deal with these complex problems, and surgeons with different specialties have been operating on these deformities, mostly as lonely experts in their respective fields. This book should not be seen as an operation atlas but more as a compact survey of a small group of medical conditions and the need for flexible options for an individual therapeutic approach, based on the combined experience of different international specialists. Thus the book is designed for obstetricians, pediatricians, physicians and surgical specialists alike.

The recent widespread application of minimally invasive techniques has had a profound impact on the diagnosis and therapy of thoracic disorders, including in the pediatric age group. This book is intended as a practical guide to the current approaches in pediatric thoracic surgery. Up-to-date information is provided on the surgical techniques employed for diagnosis and therapy in a wide range of congenital and acquired thoracic pathologies from the prenatal age to adolescence. Among the disorders considered in detail are cystic malformations of the lung, chest wall deformities, diaphragmatic hernias, esophageal anomalies, mediastinal tumors, laryngeal anomalies, and thoracic infections. The authors are distinguished experts in the field from across the world. Pediatric Thoracic Surgery will be of value not only for pediatric thoracic surgeons but also for adult thoracic surgeons, pediatric anesthetists, and pediatric respiratory physicians.

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. This first volume comprises three elements -- "physiological notes," "technical notes," and seminal studies. The physiological notes concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The technical notes then succinctly explain some of the basics of "how to" in this technology-centered field of critical care medicine. Finally, a number of seminal studies are provided on diverse topics in intensive care. Applied Physiology in Intensive Care, written by some of the most renowned experts in the field, is an up-to-date compendium of practical bedside knowledge that will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.

Each chapter describes a very specific aspect of Achalasia by its known expert. Current diagnostic and management strategies of Achalasia, as well as the simplified operative approaches with relevant technical considerations, are outlined for the specific target audience.The treatment of Achalasia is complex and usually performed in specialized tertiary-care centres. The Editors' main goal is to render this disease more understandable and accessible to residents, fellows, and specialists in both the surgical disciplines (general surgery and thoracic surgery) and in gastroenterology.

Indications for central venous cannulation in critically ill patients have increased dramatically, but central venous access has the drawbacks of morbidity and a scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team. The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on choice of materials; maneuvers for positioning of peripherally inserted central venous catheters (PICCs), techniques for evaluation of PICC tip placement; prevention, diagnosis, and management of complications; and organization of a dedicated team within a hospital or a supportive care program. Legal and economic issues are also considered. The book will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.