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.

Interventional cardiology is a creative, innovative, and rapidly advancing frontier of cardiology. There has been mind-boggling proliferation of tech nology in this field, the use of which requires extraordinary skills and know how. In order to keep pace with the innovative genius of interventional cardiologists, it is indeed desirable to have specialty issues updating us on technology-orientated therapeutic procedures. Contemporary interventional cardiology care is a highly specialized art, dependent on critical decision making, selection of the most appropriate inter ventional procedure, and the operator possessing extraordinary skills and compassion. This first volume of the new series, Supported Complex and High Risk Cor onary Angioplasty, attests to the preceding statement. Dr. Fayaz Shawl has mastered the procedure and has been very thoughtful and innovative in the clinical application of the percutaneous cardiopulmonary bypass support tech nique. This book provides to an interventionist the basic principles of car diopulmonary bypass, identification of the high risk coronary angioplasty patient, and other alternate support devices for myocardial protection. Dr. Shawl and his team of talented contributors are to be complimented for providing us with this impressive volume on high technology. There will be ongoing specialty issues in this series highlighting the devel opments, complications, and advances in interventional cardiology.

Heat shock proteins (HSP) were originally described in heat-shocked drosophila by Ritossa in the early 1960's. In the last 5 years it has become apparent that these heat shock proteins have important functions both in the normal cell and in the stressed cell. These proteins constitute an endogenous protective system; mutations in the heat shock proteins can be lethal, and there are no known organisms without heat shock proteins. The first observations on heat shock proteins and the heart were made in the 1980's and interest in these proteins increased over the decade. In the last few years there has been an exponential growth in number of papers published on heat shock proteins and the heart. Heat shock proteins have been implicated in a number of cardiovascular research areas including ischemia, hypertrophy, aging, and atherosclerosis, and this list is growmg. The purpose of this volume is to give an overview of our current understanding of the heat shock proteins in the cardiovascular system, and to summarize the approaches to the study of heat shock proteins in the heart. This volume assembles results from a number of different cardiovascular fields. and provides a comprehensive review of heat shock proteins in the cardiovascular system.

Despite approximately 50 years of progress in the management of com plex congenital heart disease, hypoplastic left heart syndrome (HLHS) has been one of the last cardiac malformations to yield to effective surgical treat ment. The surgical therapies for hypoplastic left heart syndrome have evolved by two quite disparate routes. One approach has been the staged reconstruc tion operations utilizing an initial operation pioneered by many but developed by Dr. William Norwood and subsequently modified by many other investigators. The first stage reconstruction operation has been refined and standardized such that the majority of infants now proceed to second and third stage reconstruc tive operations culminating in a Pontan Kreutzer single ventricle physiology. An alternative surgical approach has been the development of neonatal and infant heart transplantation for HLHS. This approach also has had a signifi cant impact on the treatment of HLHS and other cardiac malformations and has been associated with good intermediate term results. Both of the thera peutic approaches devised for treatment of hypoplastic left heart syndrome have been effective and the outcomes are continuing to improve with each.

Venous valves rank among the smallest and most delicate organs of the human and animal bodies - so why devote an entire book to them? We were induced to do so by several reasons. First of all we would point out the clinical significance of venous valves. In the pathogenesis of a number of widespread diseases, such as varicose veins or the post-thrombotic syndrome, venous valves are involved as the underlying cause or at least a factor contributory to the symptoms. According to Taheri et al. these venous diseases occur ten times more frequently than arterial obliterations. Incompetence of venous valves also plays a causal role in varicocele, the most frequent cause of male infertility. But not only pathogenetic reasons induced us to write this book. In more recent times there has been a growing tendency to reconstruct functional valve disorders therapeutically; several surgical methods have been developed, which are critically reviewed in this book. It was our aim to sum up existing knowledge with respect to structure and function of venous valves and to expand that knowl edge by findings of our own. Examinations of semi-thin sections and unilayered en-face preparations have hardly been published so far, and systematic studies of the ultrastructure by electron-microscopy were not to be found in the literature. We are very grateful, therefore, to Dr. Silvana Geleff for having undertaken such a study upon our suggestion."

This monograph highlights modern concepts of brain ischemia and strategies of neuroprotective therapy. The first part of the book is devoted to mechanisms of ischemic brain damage. The authors present the results of their own clinical and experimental studies conducted in the last two decades, as well as the achievements of native and foreign neurological researches that open a new stage in understanding how reversible changes of blood flow and metabolism are transformed into a permanent morphological lesion, i.e. brain infarction. The most important advances in areas of ischemic energy failure, main mechanisms of the glutamate-calcium cascade, influence of metabolic acidosis on ischemic damage, delayed neuronal death connected with microglial activation, local inflammation, autoimmune reactions, trophic dysfunction, and apoptosis, as well as of reaction of the stress-mediating endocrine system to focal brain ischemia are shown in animals and humans, and the relevant literature is cited and critiqued.The book also explores topics that recently have experienced substantial growth, such as gene expression and subsequent molecular events in response to acute brain ischemia, connected with both tissue damage and reparation. The authors demonstrate not only universal features of the process of brain ischemia, but also individual peculiarities of its course in patients and analyse their reasons.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize

Following the advent of percutaneous balloon vel oped and are available for clinical use, as well angioplasty, interventional cardiovascular pro as those that are still in investigational phases. cedures have become of great interest to the Clinical case reports are presented by expert in cardiologist, radiologist, and cardiovascular vestigators on the use of various catheter systems surgeon. One of the most extensively explored in the coronary and peripheral circulation. alternatives to bypass surgery is laser-mediated Part V (Chapters 17-23) is the most up-to angioplasty. The fascination with laser radia date review of the clinical experience with vari tion has greatly contributed to its popularity, ous laser delivery systems. There is an emphasis but has also burdened it with unrealistic ex on patient selection, criteria for lesion choice, pectations. Many commercial laser systems are and follow-up data. A detailed description of available to the clinician and the researcher, laser recanalization techniques is presented for which often makes the choice of a laser system the various systems in the clinical setting."

Brain injury is one of the most unacceptable complications sustained during heart surgery. This book presents the current results and thinking of a number of leading clinical investigators in this area. Nearly all have been active in serious studies designed to define various aspects of brain physiology, patho physiology, or protection during cardiac operations performed with cardio pulmonary bypass. We were particularly interested in obtaining contributions from younger investigators. Brain injury is a problem which has long troubled those involved with perioperative care of the cardiac surgical patient. The first chapter by Dr. Torkel Aberg presents a summary of his extensive investigations into this problem. It is intended both to present the perspective of a surgeon interested in this problem, and to serve as an introduction to the overall issue of avoiding brain injury during heart surgery. The next three chapters discuss the problem of perfusion pressure, outcome, and brain blood flow. Dr. Sarnquist's contribution stems from his extensive experience with low flow bypass as practiced at Stanford University and the results of the studies he performed in collaboration with Dr. Fish. Drs. Govier and Reves discuss in some detail the general effects of anesthetic agents upon brain metabolic needs as well as their important data demonstrating preserva tion of brain blood flow autoregulation during cardiopulmonary bypass (CPB) as practiced at the University of Alabama. Finally Dr."

Our understanding of the pathophysiology of acute myocardial infarction has grown enormously in recent years. This has led to an increasingly aggressive approach to management, designed to blunt the extent of infarction by salvaging acutely ischemic myocardium. Alternatives now include throm bolysis, PTCA with and without prior thrombolysis, and emergency bypass surgery, as well as the more aggressive use of a variety of drugs. This book consists of a series of chapters by experienced cardiologists and cardiovascular surgeons that present today's state of the art in managing acute myocardial infarction. It is written with the purpose of presenting practical approaches of value to the clinician related to the more complex problems faced in dealing with patients undergoing myocardial infarction. xi EARLY INTERVENTIONS IN ACUTE MYOCARDIAL INFARCTION 1. MANAGEMENT OF ARRHYTHMIAS IN THE CORONARY CARE UNIT NORA GOLDSCHLAGER, RODERICK WOODS, AND NEAL BENOWITZ With the advent of coronary care units, mortality from cardiac arrhythmias occurring during acute myocardial infarction has been unquestionably and dramatically reduced. In addition, continuous electrocardiographic monitoring has resulted in the recognition of specific arrhythmias related to acute ischemic heart disease and thus to the development of appropriate strategies for their management. This chapter will review certain specific aspects of those bradyarrhythmias and atrial and ventricular tachyarrhythmias that are seen most commonly in acute myocardial infarction. Pharmacologic therapy, including the use of some of the newer antiarrhythmic agents, will be discussed, as will pacemaker ther apy of both bradyarrhythmias and tachyarrhythmias."

It is a great pleasure and honor to be asked to participate in the translation of this important and historical volume on thoracic surgery and to provide this foreword. Martin Kirschner of Mannheim/Heidelberg was an early pioneer in thoracic and esophageal surgery. His operation for bypass of the esophagus using the entire stomach remains a standard of the surgical armamentarium to this date. The original Kirschner Textbook of Surgery was a standard in its day. We are fortunate that Professors H. Pichlmaier and F.W. Schildberg and other colleagues have provided us with this important modern successor of a classic textbook. The reader is rewarded by an extensive treatise which includes not only the most up to date techniques in pulmonary, esophageal, mediastinal, and chest wall (including breast) surgery but also provides an excellent perspective on the techniques used by pioneers in the field. Although some of these early techniques are not commonly used today, knowledge of their use and application broadens the capability of the thoracic surgeon. Changing times bring renewed problems with infectious diseases. Knowledge of the management of the pleural space and pulmonary infectious problems is a critical part of the education of the thoracic surgeon.

Offering a unique, multidisciplinary approach to the complexities of CPB, the 4th Edition of Cardiopulmonary Bypass and Mechanical Support: Principles & Practice remains the gold standard in the field. This edition brings you fully up to date with every aspects of cardiopulmonary bypass, including new information on management of pediatric patients, CPB's role with minimally invasive and robotic cardiac surgery, mechanical circulatory support, miniaturized circuits and CPB, sickle cell disease and CPB management, and much more. A newly expanded title reflects the rapidly evolving nature of extracorporeal technology, encompassing both short-term and long-term forms of cardiac and pulmonary support. Key Features The most comprehensive and authoritative text in the field, widely used by anesthesiologists, perfusionists, and cardiothoracic surgeons, as well as intensive care specialists, neonatologists, and interventional cardiologists. Provides expert, full-color guidance on equipment, physiology and pathology, hematology, clinical applications, and neonates, infants, and children. Addresses univentricular and biventricular assist devices, as well as the various forms of extracorporeal pulmonary support that may or may not include circulatory assistance. Includes a brand-new look at the Development of Cardiopulmonary Bypass, offering an up-to-date analysis of the history of the field. Two new co-editors, Drs. John W. Hammon and Barry D. Kussman, provide a fresh perspective and additional expertise. 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

It is a great pleasure for me to contribute a brief introduction to this volume, to which so many of my colleagues at Groote Schuur Hospital and the University of Cape Town Medical School have contributed. Though considerable advances have been made in preventing or treating the complications of heart transplantation, even today a transplant pro gramme remains a major undertaking for a hospital team. The acquisition of a sufficient number of donor hearts, the maintenance of viability of those hearts, and the prevention, diagnosis and treatment of acute and chronic rejection and infection remain major challenges to those caring for patients undergoing this operation. A transplant programme draws into it medical, surgical, nursing and paramedical staff from all quarters of the hospital and medical school, and requires sustained interest and dedication if patients are to be brought successfully through the procedure. If relevant experimental research is also to be carried out at such a centre, which in my opinion is essential, then an even greater number of highly skilled and creative people is required. A few of the authors of this book have been involved with the Groote Schuur heart transplant programme since its inception in December 1967 with the operation on Louis Washkansky. I am sure that none of them (nor I) had any idea of the public interest this operation would attract."

A definitive, comprehensive text on the technological developments and clinical applications of this critical subject matter. Written for the entire heart surgery team, this volume covers the physiology of cardiopulmonary bypass, mechanics and components of the heart-lung machine, the conduct of cardiopulmonary bypass in cardiac surgery, non-cardiac applications of cardiopulmonary bypass, and mechanical assistance of the failing heart and lung. The authors also give special consideration to such areas as blood conservation in cardiac surgery, religions objections to blood transfusions, medical-legal aspects and cardiopulmonary bypass, as well as warm blood cardioplegia and normothermic cardiopulmonary bypass.

The International Symposium on Artificial Heart and Assist Devices has been held three times, first in 1985, then in 1987 and 1990. It is my great pleasure to present Artificial Heart 3 (Proceedings of the 3rd International Symposium on Artificial Heart and Assist Devices). The third symposium was held in Tokyo on February 16 and 17, 1990. Our original intention was to invite all the principal investigators from the major artificial heart research laboratories in the world, in the first three symposia. The numbers of investigators in the fields of the artificial heart, ventricular assist systems, and biomaterials, invited for the symposia, totalled 7 in 1985, 8 in 1987, and 13 in 1990. The program of the third symposium consisted of 41 papers; 13 invited lectures, 8 papers contributed upon request, with 2 from the United States, and 20 regular selected papers including 2 from the United States, ana 1 each from Australia, Germany, and South Korea. During the last three years, the state of clinical application of artificial hearts and assist devices has changed. In the case of pneumatically driven blood pumps, we have now stepped into the age of practical use in patients. Accordingly, in this symposium we gave a special emphasis to topics of clinical application, particularly the use of an artificial heart as a bridge to heart transplantation. Sessions on implantable artificial hearts, biomaterials for the artificial heart, and heart transplantation were also included.

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."

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.

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.

This book provides an unbiased and evidence-based guide to the potential role of interventional pulmonology as an alternative to thoracic surgery. Interventional pulmonology is a new and quickly growing sub-specialty in pulmonary medicine and increasingly more pulmonologists are turning to interventional therapies over the more costly and invasive surgical options. The text thoroughly presents detailed coverage of and diagnostic methods for many diseases and conditions that pulmonologists encounter daily, including: diffuse lung infiltrates, solitary lung nodule, undiagnosed exudative pleural effusion, pneumothorax, hemoptysis, and airway foreign body. Experts then detail treatment options, from both a surgical and interventional perspective, with guidance on: when each procedure is most appropriate, what can be performed by a pulmonologist (with guidelines on how those procedures are done) versus what needs to be referred to a thoracic surgeon or an intervention pulmonologist, and the benefits and disadvantages involved with each option. This is an ideal guide for pulmonologists, trainees, and students to better understand the full scope of possible treatment options for their patients and to make the best informed decision about patient care.

This book provides a detailed account of the principles and practice of contemporary lung transplantation. An accomplished, international team of contributing authors have combined their expertise to provide scientific developments and clinical knowledge based on their extensive experience. The book covers pulmonary vascular and parenchymal lung disease, which necessitate transplantation, together with all aspects of the multidisciplinary management of lung transplant patients. It concludes by looking at future developments in the treatment of advanced respiratory failure. This multidisciplinary approach makes the publication suitable for several subspecialities in addition to pulmonary medicine and lung transplantation, including haematology, radiology and clinical psychology. It will serve as a valuable source of reference and practical information for medical specialists in transplantation and all those working in thoracic organ transplant units.

This thesis addresses computation fluid dynamics modelling of aortic dissection (AD), in order to generate in silico diagnostic information and assess 'virtual surgery' outcomes. The thesis introduces several important advances in the modelling of aortic dissection and lays essential groundwork for further development of this technology. The work thesis represents a unique and major step forward in our understanding of AD using a patient-specific, systematic and coherent simulation approach, and is currently the most advanced work available on AD.

Key Clinical Topics in Cardiology presents a brand new addition to the Key Clinical Topics series. The book provides a comprehensive overview of the subject, comprising over 60 carefully selected topics in alpha order that together provide an extensive understanding of the management of cardiovascular disorders. This collection of highly practical guides systematically addresses management techniques for a large number of clinical settings. Edited by experienced specialists, with contributions from consultants who have recognised expertise in their field, this book provides an authoritative and up-to-date guide on cardiovascular medicine. Designed to enable rapid access to core information, KCT Cardiology offers effective exam revision and the ideal quick reference for day-to-day practice. Key points Over 60 topics presented in alpha order, from acute advanced life support to tumours Effective exam revision for postgraduate trainees in cardiology preparing for certification Succinct coverage of cardiac treatment modalities and complications Includes clinical photos and diagrams to improve understanding of concepts Contributions from experienced specialists to ensure authoritative, accurate content

Take your surgical skills to the next level with Thoracic Surgery: Transplantation, Tracheal Resections, Mediastinal Tumors, Extended Thoracic Resections, a volume in the Master Techniques in Surgery Series! This thoracic surgery reference provides the richly illustrated, step-by-step guidance you need to perfect a full range of thoracic surgery techniques, avoid and manage complications, and achieve optimal outcomes. Key Features See exactly how to perform the full range of procedures , both open and minimally invasive, for lung transplantation, thoracic outlet syndrome, pectus repair, diaphragmatic plication, and removal of mediastinal tumors. Gain insights from international authorities , gleaning each expert's preferred techniques in rich detail. Efficiently review background, indications and contraindications, surgical techniques, avoidance of pitfalls, and management of complications and results for each procedure, as well as selected references for further reading. Don't miss Thoracic Surgery: Lung Resections, Bronchoplasty , the companion volume by Drs. Mathisen and Morse. Expand your repertoire with other volumes in the Master Techniques in Surgery Series! Overseen by Josef E. Fischer, MD , editor of the classic two-volume reference Mastery of Surgery , these titles cover a wide range of common and advanced procedures in the major subspecialties of general surgery, including breast surgery, colon and rectal surgery, esophageal surgery, gastric surgery, hepatobiliary and pancreatic surgery, and hernia. Now with the print edition, enjoy the bundled interactive eBook edition , offering tablet, smartphone, or online access to: Complete content with enhanced navigation A powerful search that pulls 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

Despite all efforts and success in medical treatment, the incidence of (end-stage) chronic heart failure is increasing. Cardiac transplantation remains the only definite option; however, due to the shortage of donor organs, very few people benefit. Therefore, surgery of end-stage heart failure using conventional techniques has gained new interest after the introduction of the Batista operation. However, a clear surgical identification of the patients to be included in this group is lacking. Left ventricular reduction surgery as well as reduction of the base of the heart using mitral annuloplasty or mitral valve replacement, sparing both papillary muscles, is used in selected patients with satisfying results and good survival. Long-term mechanical support with subsequent surgical remodeling or supporting myoplasty may result in a beneficial alternative to heart transplantation.

Pediatric cardiac surgery is a dynamic, fast-moving field. Busy practitioners, like you, need clear and comprehensive guidance you can rely on to ensure optimal patient care.

For over 25 years "Pediatric Cardiac Surgery" has been the gold-standard reference for pediatric and adult congenital heart surgeons, pediatric and congenital cardiologists, intensivists, anesthesiologists, residents and nurses.

Now, in this thoroughly revised fourth edition, you again get trusted, complete coverage of the field with timely new features and expert reviews of critical topics including heart transplantation, emerging modalities for diagnosing congenital heart and tracheal defects, the surgical technique of Fontan conversion with arrhythmia surgery, the medical challenges of managing adult CHD patients, and more.

This new edition includes: Contributions from over 65 world-renowned expertsMore beautiful illustrations, by renowned medical illustrator Rachid Idriss, which have brought acclaim to previous editionsReviews of the embryology, physical findings, diagnostic criteria, and therapeutic choices for each disease entity and describes the latest in surgical techniques in each chapterAll-new chapters that guide readers through new treatment options and other key developments since the publication of the third edition highlighting recent advances in congenital heart surgery.All-new new chapters that review advances in right ventricular to pulmonary artery conduits, arrhythmia surgery, double outlet ventricles, and adult congenital heart disease, among other key topics.