50 Studies every Vascular Surgeon Should Know presents key studies that have shaped the practice of Vascular Surgery. Selected using a rigorous methodology, the studies cover topics including carotid artery disease, aortic aneurysm, peripheral artery disease, trauma, venous disease and vascular access. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implication for practice. An illustrative clinical case concludes each review to highlight the impact of the study on clinical practice. This book is a must read for vascular surgeons, especially those in training and preparing for board exams, as well as anyone who wants to learn more about the data behind clinical practice.

Artificial hearts are seductive devices. Their promissory nature as a cure for heart failure aligned neatly with the twentieth-century American medical community's view of the body as an entity of replacement parts. In Artificial Hearts, Shelley McKellar traces the controversial history of this imperfect technology beginning in the 1950s and leading up to the present day. McKellar profiles generations of researchers and devices as she traces the heart's development and clinical use. She situates the events of Dr. Michael DeBakey and Dr. Denton Cooley's professional fall-out after the first artificial heart implant case in 1969, as well as the 1982-83 Jarvik-7 heart implant case of Barney Clark, within a larger historical trajectory. She explores how some individuals-like former US Vice President Dick Cheney-affected the public profile of this technology by choosing to be implanted with artificial hearts. Finally, she explains the varied physical experiences, both negative and positive, of numerous artificial heart recipients. McKellar argues that desirability-rather than the feasibility or practicality of artificial hearts-drove the invention of the device. Technical challenges and unsettling clinical experiences produced an ambivalence toward its continued development by many researchers, clinicians, politicians, bioethicists, and the public. But the potential and promise of the artificial heart offset this ambivalence, influencing how success was characterized and by whom. Packed with larger-than-life characters-from dedicated and ardent scientists to feuding Texas surgeons and brave patients-this book is a fascinating case study that speaks to questions of expectations, limitations, and uncertainty in a high-technology medical world.

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.

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.

This book offers a historical account of the development of the On-X carbon mechanical heart valve, discussing the steps involved in developing the materials, and describes how the design of the valve has evolved over the years. It explores both the scientific and corporate problems researchers have encountered over the years in the journey of making a mechanical heart valve. The chapters provide a detailed description of the design of the mechanical leaflet-based prosthetic valve, with a particular focus on blood flow characteristics. This book includes an overview of the state-of-the-art in the chemistry and physics of carbon, and compiles the advances in carbon-based technology and its applications in cardiac and thoracic surgery. This is an ideal book for bioengineers working on the chemistry and physics of carbon, and other professionals involved with cardiac and thoracic surgery.

The third edition of Cardiopulmonary Bypass offers a comprehensive, and up-to-date reference text to extracorporeal cardiopulmonary support. This book provides a clinically-focused tutorial with chapters spanning the technical aspects, patient related considerations, and human factors essential to contemporary practice of cardiopulmonary bypass. Written concisely to allow the reader to gain and apply critical knowledge to the clinical setting and featuring artwork that has been extensively updated to include numerous figures and color plates imbedded into each chapter. A remarkable collection of international experts in the fields of perfusion, anesthesiology, and cardiac surgery were recruited to co-author chapters, providing a multidisciplinary approach to case management. This completely updated edition includes expanded content on developments in minimally invasive extracorporeal circulation, anticoagulation, organ injury, and human factors. The comprehensive coverage of perfusion practice in a concise, highly illustrated format makes it the go-to, portable reference manual for perfusionists, cardiac surgeons, and anesthesiologists.

This text serves as a convenient one-stop resource on the pathogenesis, diagnosis and treatment of kidney diseases in context of advanced heart failure and presence of ventricular assist devices. Advances in managing heart failure, evidence-based practices and therapies are covered, along with the management of this unique and complex subset of patients. The book also provides insights into combined heart and kidney transplantation. Authored by leaders in nephrology, cardiology and transplantation, this book fills a critical knowledge gap in understanding and treating patients with acute or chronic dysfunction of the heart and kidneys and how one induces dysfunction in the other organ.

This book represents the first European effort to provide a collection of test descriptions used in evaluation of the compatibility of biomaterials in contact with tissues and blood. The urge to compile this book arose from the fact that it is the properties of the material which ultimatively seem to determine the functional outcome of a medical device, almost regardless of how ingenious the construction of the very device is. The longer the exposure is, the more important these basic properties become. Unfortunately only a small part of the interactive phenomena is fully elucidated and understood. This challenge reflects itself in an effort to cover numerous aspects of testing, beginning with fundamental analysis of the material, continuing with the mechanical properties, the resistance to degradation and the analysis of surface and chemical properties including adsorption patterns of proteins ending with test on cell cultures, ex vivo and in vivo. A number of the tests which are generally accepted as being important are already described as official requirements (primarily Pharmacopeas). These official requirements are not included in order to limit the size of the book. It is the aim of this book to present the tests like a recipe in a uniform way to ease the reader in finding his/her way through the material and to present it as a kind of "cook-book" in an order to provide an easy access to copy the procedures. This has unfortunately not been possible in all circumstances.

With a large volume of ultrasound images and teaching videos, Pleural Ultrasound for Clinicians: A Text and E-book is a print and interactive digital resource that provides practical guidance for all those undertaking pleural ultrasound investigations and procedures. With clear, precise instructions for clinical practice, it will help clinicians: Recognise normal anatomy as well as common pleural pathologies Perfect techniques for ultrasound-guided pleural procedures Learn how to choose the correct ultrasound equipment for their department Test their knowledge through the self-assessment and revision sections

The topic of heart failure although extensively researched and reported, has several gray areas. This is especially seen in determining strategies for combating advanced heart failure. The global burden of ischemic heart disease is increasing at an alarming rate to almost pandemic proportions. Even in the presence of state-of the art technology for prompt and successful coronary reperfusion, the population progressing to ischemic cardiomyopathy is substantial. The treatment strategies for ischemic cardiomyopathy do not always ensure optimal clinical results, the reasons for which are varied. The proper patient selection is vital as is the tailoring of suitable therapy. The approach is thus multi-pronged, of which surgical ventricular restoration (SVR) has a definite role. Despite various randomized studies like the STICH-hypothesis 2, where there was a huge selection bias, with patients subjected to an erroneous technique of SVR, with inadequate ventricular remodelling assessment. The present need is to understand the unique anatomy of the left ventricle, its function and perturbations with the onset of heart failure, in order to plan therapeutic strategies to restore near normal anatomy and function. A study of the hemodynamics in ischemic cardiomyopathy is essential, as it differs in certain aspects from other causes of heart failure like idiopathic dilated cardiomyopathy and valvular heart diseases. Since information on these aspects are scattered in various scholarly articles, a concise source in the form of a book would be appropriate and useful for both cardiologists and cardiac surgeons. This project represents a concise review of normal and abnormal cardiac anatomy and physiology, the evolution of SVR to EVLPP with validation of near normal ventricular restoration, plus act as a reference guide for cardiac surgeons with interest in SVR.

Topics include basic considerations and techniques, venous drainage of the myocardium, structure and function of the cardiac lymphatic system, coronary sinus interventions in experimental research, and more.

As societies have aged and aortic diseases have become more prevalent, advances in diagnostic imaging and surgical techniques have brought significantly improved results for patients. In cardiovascular surgery, important questions remain to be addressed, however. "Strategy for Cardio-aortic and Aortic Surgery" was the theme of the 7th Keio University International Symposium for Life Sciences and Medicine. Meeting in Tokyo, researchers and specialists in cardiac surgery from around the world discussed crucial issues in their field. Papers from the symposium, collected in this volume, cover a broad range of topics, including recent advances in diagnostic imaging, brain protection during aortic surgery, spinal protection during thoracoabdominal aneurysm repair, treatment of type A acute aortic dissection, and stent-grafts and less-invasive aortic surgery. This unique book provides valuable information especially for aortic, cardiovascular, and thoracic surgeons.

Since the publication of the first edition of Cardiac Pacing for the Clinician, the use of implantable cardiac devices has expanded rapidly. Certain classes of devices such as implantable loop recorders and cardiac resynchronization pacing systems were not commonly used when the first edition was published, and recent studies have shown that implantable cardioverter defibrillators are beneficial in large, previously unrecognized patient populations at risk for sudden death. In order to meet this demand, cardiologists without special training in electrophysiology or pacing are implanting an increasing number of cardiac devices. It is in this rapidly evolving setting that Cardiac Pacing for the Clinician, Second Edition is being undertaken.

The main focus of this volume will be to provide a practical discussion of the a oenuts and boltsa of implantable cardiac devices. The target audience will be cardiologists in practice and in training as well as nurses, technologists and industry. In addition, it will benefit physicians preparing for certification.

Additions to the new edition will include: Chapters discussing new cardiac devices; Implantation of Left Ventricular Leads for Cardiac Resynchronization Pacing Systems; Identification of Candidates for Cardiac Resynchronization Therapy; Follow-Up Issues in Cardiac Resynchronization Therapy; Implantable Loop Recorders.

Updates to the existing chapters will include: New Trial Information & Follow-Up of the Newest Generation of Defibrillators; Use of Defibrillators in Patients at Increased Risk for Sudden Cardiac Death due to Long QT Syndrome, Brugada Syndrome and Congenital Heart Disease; Updates to Lead Extraction a" NewTechniques and Tools; Cardiac Pacing chapter will shift focus to Cardiac Devices.

This new edition of Cardiac Pacing for the Clinician, Second Edition will become a valuable resource to the general cardiologist and cardiology fellow by providing practical information for managing patients with complex cardiac devices.

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.

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.

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.

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.

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.

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.