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This issue of Thoracic Surgery Clinics of North America, guest edited by Dr. Joshua Sonett, is devoted to Thymectomy for Myasthenia Gravis. ?Dr. Sonett has assembled expert authors to review the following topics: Role of Thymus in the Immune System; A Neurologist's Perspective to Understanding Myasthenia Gravis: Clinical Perspectives of Etiology, Diagnosis and Preoperative Treatment; A Neurologist's Perspective on Thymectomy for Myasthenia Gravis: Current Perspective and Future Trials and Medications; Surgical Approaches to Myasthenia Gravis: Perspective of Anatomy and Radicality in Surgery; Surgical Techniques for Myasthenia Gravis: VATS; Surgical Techniques for Myasthenia Gravis: RATS; Surgical Decision Making: Thymoma and Myasthenia Gravis; Immune Syndromes and the Thymus: Is There a Role of Thymectomy?; Surgical Techniques for Myasthenia Gravis: Transcervical; Surgical Technique for Myasthenia Gravis: Subxyphoid Approach; History of Thymectomy for Myasthenia Gravis; and more!
This book will systematically cover all the main topics involved in the current practice of a cardiac surgeon. It will incorporate current guidelines for practice (such as from the American Heart Association and European Society of Cardiology) and up-to-date information based on current literature. All the chapters have been written by cardiac surgeons who have recently undertaken their Cardiothoracic Board / Specialty Exit examinations and reviewed by a cardiothoracic examiner of the Royal College of Surgeons of England. Each chapter will be structured to include aetiology, pathophysiology, clinical features, indications for surgery, peri-operative management, surgical options and postoperative care. Possible complications will be discussed and the results of current practice presented. Importantly there will be a section on basic sciences related to the practising cardiac surgeon and a further section on cardiac investigations with many images illustrating the variety of pathologies. Each chapter will also contain important references for further reading and greater depth of knowledge. The data and body of knowledge presented in this book is strictly evidence-based and is relevant to all cardiac surgical trainees, at any stage of their training programme. It will provide interns, residents and specialist registrars the necessary information to carry out their daily duties. Adult cardiologists and cardiothoracic intensive care unit specialists will also find the book useful in terms of the indications and surgical management of these patients, as they are integral to the cardiac surgical process. Another important group is the nursing staff, physiotherapists and other professions allied to medicine, both surgical and cardiological, working with patients with adult cardiac disease either pre-operatively or postoperatively, as it will help to give a detailed understanding of the principles surrounding adult cardiac surgical disease. Most importantly, the book is ideal as a revision aid for residents/registrars undertaking their Cardiothoracic Surgery Board examinations around the world. Although these examinations vary in format in different countries, this book is applicable to all cardiothoracic surgical trainees. Its concise, yet complete coverage of the important topics, make it the ideal guide to answer the key questions in cardiac surgery that are asked within the confines of an examination.
This practical book describes a systematic approach to the ultrasound examination of the fetal heart based on accepted screening recommendations. The written content is enhanced by images and videos of both normal and abnormal sonographic findings. Fetal Cardiology: A Practical Approach to Diagnosis and Management goes further than simply describing core screening views. It includes extended views of the fetal heart, the use of Doppler techniques and assessment of fetal cardiac function. "Variants" which can be encountered in practice are described as well as the features of the major groups of cardiac abnormalities and fetal arrhythmias. Because the authors include experienced fetal and paediatric cardiologists, the focus is not only on diagnostic features but also the approach to postnatal care and prognosis. This content is enhanced by inclusion of chapters relating to associated fetal abnormalities, the genetics of congenital heart disease and new imaging modalities such as MRI of the fetal heart. The book equips all those using ultrasound to image the fetus with a clear concise reference to meet the challenge of new guidelines and to expand their knowledge of complementary echocardiographic techniques and management. It details why prenatal recognition of congenital heart disease is being prioritised to allow for parental choice, recognition of associated abnormalities and improvement of postnatal outcome. As such, this book will be important for all professionals, whether they be a cardiologist, fetal medicine specialist, sonographer or midwife.
The new Oxford Textbook of Cardiothoracic Anaesthesia provides a comprehensive overview of and a thorough grounding in this challenging subspecialty. Both cardiac and thoracic anaesthesia demand high levels of knowledge and skill, as minimally invasive surgical techniques demand a sounder understanding of the specialties and as more patients with co-morbidities present for surgery. Part of the Oxford Textbooks in Anaesthesia series, this volume covers the anatomy and physiology, pharmacology, post-operative complications, critical care, and all clinical aspects of cardiac and thoracic anaesthesia. Practical aspects, such as team working, and designing and equipping cardiothoracic theatre and critical care, are also included. The expert and international author team use their experience to ensure this textbook reflects current world-wide practice across the globe. This volume is published with a concurrent online version, which features access to the full content of the textbook, contains links from the references to primary research journal articles, allows full text searches, and provides access to figures and tables that can be downloaded to PowerPoint (R). Designed for consultants and trainees in cardiac and thoracic anaesthesia, this is the definitive source of expert knowledge for anaesthetists in this subspecialty. This print edition of Oxford Textbook of Cardiothoracic Anaesthesia comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables. Oxford Medicine Online is mobile optimized for access when and where you need it.
This clinical casebook is comprised of surgical cases involving the most important cardiovascular diseases in a concise, easy-to-read format (5x8 in trim size, like other titles in this burgeoning, informal product line in the Springer clinical medicine program).Each chapter is a case that opens with a unique clinical presentation, followed by a description of the diagnosis, assessment and management techniques used to treat it, as well as questions and answers (between 8 and 10) about relevant aspects related to the diagnosis and treatment of the addressed disease. The Q&A section will broaden discussion and increase the title's pedagogical value. The casebook features 40 surgical cases in the following thematic areas: Aortic Disease, Arrhythmias, Cardiac Tumors, Coronary Insufficiency, Congenital Heart Disease, Endovascular Therapies, Heart Failure, Heart Transplantation, Mechanical Circulatory Support, Pericardial Disease, Pulmonary Embolism and Valvular Heart Disease. This book will be prepared by the Brazilian Department for Academic Leagues of Cardiovascular Surgery, within the Brazilian Society of Cardiovascular Surgery (BSCVS). This department is the section within BSCVS that consists of the academic leagues of cardiovascular surgery from each university throughout the country. In Brazil, medical academic leagues are organizations that gathers students, interns and residents to discuss a certain topic and promote research and teaching-oriented extra-class activities, supervised by a group of professors. Thus trainees will have involvement in writing the chapters and the senior professor supervisors will edit and finalize the work. Basically, each chapter is written by an intern or resident and, ultimately, his/her supervisor. As the books volume editors, doctors Almeida and Jatene will have final responsibility for the cases and overall manuscript.
This book covers all aspects of successfully treating patients using chest drains, beginning with anatomy and ending with physiotherapy and pain management. The aim of the book is to provide medical professionals with a step-by-step guide to using a chest drain, with specific chapters on indications, kinds of chest drains, catheters, drainage systems, how to insert a chest tube, complications during placement and handling of a chest drain, removing a chest drain, management of the pleural space and post-procedural care. Unlike general thoracic surgery textbooks, this book gives a complete overview of chest drains in clinical practice to ensure the best possible care of patients.
This book provides comprehensive, state-of-the art insights into aortic valvuloplasty. Aortic valve repair is a relatively new procedure. Since first being successfully performed in the 1990s was objectively assessed in the 2000s, this procedure has now become standardized, reproducible, and popular around the globe. Written by experts in surgery and cardiology and richly illustrated, it discusses the aspects of anatomy, pathophysiology, diagnosis and surgical procedure that are essential for successful repair. Contributing to the popularization and development of aortic repair, it is a valuable resource for surgeons, cardiologists, cardio-anesthetists and paramedical staff interested in the field and will be good resource for popularizing and developing aortic valve repair.
This book is intended to be a link between guidelines and clinical practice, a complementary tool to help physicians to be well informed regarding the important field of heart failure. It will be a useful tool for professionals from all the fields of cardiology: non-invasive cardiology, interventional cardiology, electrophysiology and cardiovascular imaging. The topic of heart failure is continuously changing, with new important information being added constantly. The pathophysiology is better understood and there is a trend for a better characterization of special groups of population, such as oncologic patients with heart failure. The new imaging techniques have become valuable tools for the diagnosis of heart failure, while pharmacological and novel cell and gene treatments have evolved enormously. The challenge for the practitioners is making the right selection of treatment strategy that best fits a patient. This book presents detailed information on the indications, selection and mechanism of action of these treatments, whether they be mechanical circulatory devices or pharmacological treatments. The contemporary pharmacological and non-pharmacological management of heart failure has the main target of early prevention of disease progression and the avoidance of heart transplant. In the era of shortage of donors, prevention is the mainstay of the therapeutic strategy, and this is the main philosophy of our book.
This issue of Interventional Cardiology Clinics will explore Updates in Percutaneous Coronary Intervention. Curated by the series Editor-in-Chief, Dr. Matthew J. Price, this issue will cover topics and advances in the field that are relevant for practicing clinicians. This issue is one of four selected each year by Dr. Price. The volume will include articles on: Current Concepts in Intraprocedural Pharmacology During PCI; Periprocedural Myocardial Infarction in Contemporary Practice; Newer Generation Metallic Stents: Design, Performance Characteristics, and Outcomes; Distal Transradial Access for Coronary Angiography and Intervention; Clinical Outcomes Data for iFR-guided PCI; Culprit-only or Complete Revascularization During STEMI in Patients with and Without Shock; Technical Approaches to Left Main Coronary Intervention: Contemporary Best Practices; Robotic Assisted Percutaneous Coronary Intervention; Orbital Atherectomy: A Comprehensive Review; and Percutaneous revascularization of spontaneous coronary artery dissection, among others.
C omplications of Percutaneous Coronary Intervention: The Survival Handbook aims to serve as a reference manual for all cardiologists, particularly those in training, who face life-threatening complications of PCI on a day-to-day basis. Drawing on the background and experience of cardiologists from both sides of the Atlantic, the book aims to be a valuable, practical, and most of all readable resource for the interventional cardiologist. The principles and practices described in the book will be of interest to all practitioners of interventional catheter procedures, including interventional radiologists, vascular surgeons, and cardiologists.Few medical procedures have evolved as dramatically or as quickly as percutaneous coronary intervention (PCI). From its initial conception, PCI has evolved to become a very complex procedure. Each year in the United States well over 1,000,000 percutaneous coronary intervention procedures are performed. However as the volume and complexity of the procedures being performed has increased, so has the potential for procedural error leading to life-threatening complications. Knowledge of what complications can occur during PCI and how to deal with them is vital for the practicing cardiologist, and can mean the difference between life and death.
This well-illustrated handbook provides answers to important questions that may arise during the retrieval of multiple organs for transplantation and offers step-by-step descriptions of current surgical techniques for procurement of the various thoracic and abdominal organs, including heart, lung, liver, intestine, pancreas, and kidney. The coverage includes detailed instruction on liver splitting techniques and on living donor liver hepatectomies and laparoscopic and robot-assisted nephrectomy for transplantation. In addition, guidance is provided on preoperative evaluation for multiorgan donation, contraindications, management for organ retrieval in deceased donors, and organ preservation. The advice offered and the questions addressed will be of relevance not only to transplant surgeons, trainees, and fellows but also to all other professionals involved in organ transplantation, including nursing staff in intensive care units and emergency rooms.
This book focuses on diverse aspects of the relationship between hypertension and brain damage, providing up-to-date information that will be of interest to both clinicians and researchers. After an introductory chapter on epidemiology, the significance of various comorbidities that represent risk factors for brain damage in the context of hypertension is discussed. Detailed consideration is then given to the effects of hypertension on small and large cerebral arteries and the consequences for brain damage. Similarly, the association between hypertension and ischemic and hemorrhagic stroke is fully explored, and the evidence and guidelines regarding reduction of high blood pressure during the acute phase of each form of stroke are summarized. Both the primary and the secondary prevention of stroke are addressed, with presentation of the results of key trials. Readers will also find interesting new perspectives on the roles of different imaging techniques, including CT and functional MRI, in detecting and diagnosing brain damage in patients with hypertension. The closing chapters review the relation of hypertension to subjective and objective cognitive failures and to cognitive decline and dementia.
Valvular heart medicine revolves around the need to accurately identify locations of pathological structures and/or the interventional tools needed to manage that pathology. The imaging of the valves is developing at an enormous pace and the clinician must be aware of the advantages of each modality and how it compares to the others available. There is a need for a practical, clinical atlas designed to work the reader through cases and assessing the gold standard choices available to physicians. This atlas will represent the full multimodality imaging decisions needed when assessing mitral valvular disorders. Within this atlas the authors will be presenting a comprehensive pictorial overview of the highly complex pathology/treatment techniques and management in this diverse group of patients with varied mitral valvular pathologies. Imaging modalities move fast representing challenge to practitioners. This atlas will enable them to learn the choices available and be well versed in techniques. It will therefore be essential reading for all cardiac imagers, surgeons, interventionalists, anesthetists and trainees in these disciplines.
Cardiac Pacing: An Illustrated Introduction willprovide an introduction to all those who have or who are developing an interest in cardiac pacing. At a time in the UK when pacing is being devolved from specialist tertiary cardiac centres to smaller district general hospitals and in the USA where pacemaker implantation is no longer the responsibility of the surgeon and in the domain of cardiologists, there is a need for a text which offers a guide to pacing issues to be used alongside a comprehensive practical training programme in an experienced pacing centre"
This book first describes medical devices in relation to regenerative medicine before turning to a more specific topic: artificial heart technologies. Not only the pump mechanisms but also the bearing, motor mechanisms, and materials are described, including expert information. Design methods are described to enhance hemocompatibility: main concerns are reduction of blood cell damage and protein break, as well as prevention of blood clotting. Regulatory science from R&D to clinical trials is also discussed to verify the safety and efficacy of the devices.
In today's healthcare environment, the real driver is value. Maximizing outcomes and minimizing costs or providing similar outcomes with lower cost in terms of actual numbers or recovery time will dominate our healthcare delivery system. An excellent example of this evolution is in the ?eld of cardiovascular intervention. Dr. Jacques Kpodonu's Manual of Thoracic Endo-Aortic Surgery is a most timely and descriptive work in this burgeoning ?eld. It provides an excellent overview of current technology and techniques, plus the endovascular expert can drill down into the details of the devices and technologies described and signi?cantly enhance their knowledge and perspective. Procedural detail, excellent graphics, pertinent imaging studies, and relevant instruction are the mainstays of this text. The ?rst chapter comprises the key overview and very comprehensively covers the platform - the hybrid OR, the tools, the accessories, and the medium - superb, state-of-the-art imaging modalities required to perform these advanced procedures. The text then moves into more technical details including options and instruction regarding access approaches and potential pitfalls of such. This is followed in en- ing chapters by dissemination of precise information, techniques, and indications for the most popular and utilized grafts including Boston Relay Stent Graft, Cook TX2 Zenith Stent Grafts, as well as the Gore and Medtronic Aortic Stent Grafts.
This book describes the different aspects of aortic valve and root diseases including comprehensive discussion of the state-of-the-art diagnostic imaging options, disease risk stratification, selection of candidates for valve repair or percutaneous intervention, and most recent therapeutic options. The growing prevalence of valvular heart disease represents a major challenge in terms of short- and long-term management and surveillance. Aortic valve diseases, including aortic stenosis and regurgitation, are among the most frequent of these, while the number of cases of aortic root disease is also on the rise. Aortic valve disease treatment options include valve surgery, valve repair, minimally invasive valve surgery, and percutaneous approaches and all are covered in this volume. Advances in Treatments for Aortic Valve and Root Diseases is a highly illustrated, case oriented reference aimed at cardiology fellows in training, while also helpful to surgeons, cardiologists, imagers, interventionalists, as well as other clinicians and students involved in the diagnosis and treatment of aortic valve and root diseases.
The revised fourth edition of this classic textbook on cardiac anatomy written from the stance of the cardiac surgeon features many new images, including computed tomography angiography. The provision of multiple high quality surgical and pathological photographs makes it essential reading for cardiac surgeons, and of great value to cardiologists, surgical pathologists, radiologists and anaesthetists. The book will also be a valuable reference resource for any healthcare professional or researcher who needs to understand detailed cardiac anatomy. The book begins by describing the surgical approaches to the heart. It goes on to discuss the normal surgical anatomy of the cardiac chambers, the valves, and the systems for circulation and conduction within the heart. This provides the essential anatomical information required to assess and interpret the malformations, lesions and abnormalities discussed in the remainder of the book.
Despite often taken as a simple procedure, techniques on tracheostomy have evolved considerably on the last few years. Consequently, new technical variations and indications for different purposes are being developed and proposed. The current book is proposed to serve as a comprehensive guide exclusively devoted to tracheostomy, discussing its most important details, variations and indications. Here the reader will find a broad discussion ranging from the most basic pre-clinical aspects to post-surgical procedures and complications. Great emphasis is placed on key topics such as the oncologic patient, variations of the technique, and tracheostomy in the intensive care unit, among others. Additionally, some issues that are not commonly discussed in regular textbooks, like tracheostomy in child and in great obese, are also included. With a wealth of photos, illustrations and tables, Tracheostomy - A Surgical Guide provides the material necessary to support a safe and effective surgical intervention in different populations and surgical contexts, with the hope that it will result in improved care for patients who underwent tracheostomy.
This book provides a comprehensive, practical and timely review of all aspects of video-assisted, minimally invasive thoracic surgery, used to treat conditions of the lung, pleura, mediastinum, chest wall and diaphragm. Advances in technologies and instrumentation mean almost all thoracic surgeries may be performed by minimally invasive techniques rather than the traditional open surgeries. This book describes the thoracoscopic procedures in current specialist practice with discussion on indications, patient selection, surgical approaches, complications and clinical outcomes. The book opens with a summary of the rationale for minimally invasive surgery and when to convert to open surgery, as well as anaesthetic and peri-operative considerations, before covering the range of procedures organised by anatomical site. Numerous figures and diagrams describe every technique in detail and an authoritative, international team of contributors provides clinical experience and expert guidance.
This book covers in detail all aspects of functional mitral and tricuspid regurgitation, from its pathophysiology and natural history, to its assessment, medical and surgical treatment, and long term results. Functional Mitral and Tricuspid Regurgitation encompasses information and knowledge from a diverse background including cardiology, cardiac surgery and basic science. This is necessary for a full understanding of the subject in order to optimally manage patients with this condition.
With a large volume of ultrasound images, ultrasound video clips, and teaching videos, this print and interactive digital book provides a practical guide for all physicians undertaking pleural ultrasound investigations and procedures. Containing instructions for clinical practice, the book will help you to: Recognise normal anatomy and common pleural pathologies Perfect techniques for ultrasound-guided pleural procedures through clear explanations supported by instructional videos Learn how to choose the correct ultrasound equipment for your department Test your knowledge through the self-assessment and revision sections
Chest Surgery provides readers with a comprehensive and authoritative text that explains and illustrates all thoracic surgery procedures, with the exception of those on the heart and esophagus. The easy-to-read text is supported by clear, instructive line drawings and intraoperative photographs. The result is a well-illustrated practical guide for the seasoned and novice practitioner alike. The contributors, who are all acknowledged experts, demonstrate simple and safe forms of operation by distilling their experience into the most efficient methods for both standard and less common procedures. For ease in following a surgical procedure, the text description of each step is coupled with an appropriate drawing. There are often numerous ways of performing an operation, and this book takes care to impart the basic principles underlying surgery. It will be the "must-have" guide for all thoracic surgery residents who wish to acquaint themselves with the latest developments in this constantly expanding field.
In recent years the approach towards rib fractures has evolved. Abandoned in the past, due to inadequate instrumentation and lack of evidence, rib fixation has recently re-emerged as a treatment option for trauma patients. There have been a number of advances over the last 25 years that now allow surgeons to internally fix rib fractures that otherwise may have not had other options. However, as a result there has been a rapid increase in literature and many institutions interested in initiating rib fixation programs. Due to a variety of practitioners involved namely, trauma surgeons, orthopedic surgeons, and thoracic surgeons there has been no comprehensive guide to patient selection, technique, and post-operative care. The purpose of this text is to fill the educational gap for those trauma, orthopedic, and thoracic surgeons interested in learning the cutting edge evidence-based approaches to treatment of rib fractures. This topic has caught the interest of many and has been a recurrent theme at surgical meetings over the last two years. Although there has been ever increasing levels of interest and experience nationally there are many questions which remain. This text will provide not only the theoretical background for improving outcomes in those with rib fractures but also serve as a practical guide to those interested in starting new programs. The text will include tips and tricks that can be used in the OR or at the bedside to improve patient care. Therefore, the focus will be on a comprehensive review but also including tips and tricks from the most experienced surgeons around the country who are performing internal fixation for rib fractures.
The field of structural heart disease interventions is experiencing a stage of rapid growth with the development of percutaneous mitral valve repair therapies and percutaneous aortic valve replacement therapies. The MitraClip represents a new therapeutic frontier for mitral regurgitation and is expected to revolutionize repair of the mitral valve. For the first time in the world, physicians now have the capability to repair the mitral valve percutaneously without the need for a sternotomy or cardiopulmonary bypass. However, as with all new endeavors, there is a steep learning curve, not just for the individual operator but also for the entire field. The MitraClip technology and technique is technically complex and is guided by echocardiography and fluoroscopy. It is an imaging intensive procedure that requires deep 3-dimensional understanding of normal and abnormal cardiac anatomy. Not all mitral regurgitation cases are suitable and not all cases are straightforward. It is therefore crucially important for physicians in this specialty to communicate their experience, successes, failures and complications with each other. Written by the leaders in this breakthrough field, the Atlas of Percutaneous Edge-to-Edge Mitral Valve Repair is the first of its kind for the new percutaneous MitraClip procedure. The Editors have designed the book to be a comprehensive reference manual and to provide cardiologists with true examples of basic and complex cases of percutaneous mitral valve repair using the technology. In addition, this book provides step-by-step guides to the procedure and complications as well as steps to recover from them are discussed. The Atlas is anticipated to be a very valuable reference for both novice and experienced interventional cardiologists and echocardiologists. As percutaneous valve repair becomes more common it will also be of great interest to general cardiologists and surgeons.
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