The aim of this issue is to provide the thoracic surgeon with information about the staging and treatment of cancer to the mediastinal lymph nodes. The issue includes articles on the anatomy and physiology of the lymph nodes, imaging of the lymph nodes, and various techniques for diagnosing and dissecting the lymph nodes, including video-assisted mediastinoscopic lymphadenectomy and transcervical extended mediastinal lymphadenectomy.

Heart disease is the leading cause of death among US women over the age of 65, resulting in more deaths than all forms of cancer combined. Women are less likely to survive heart attacks than are men, possibly because symptoms in women may differ and may be less recognizable.? In addition, women consistently tend to have worse clinical outcomes in percutaneous coronary interventions than do men. For these reasons, an issue on percutaneous interventions in women is timely.

Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" covers all stages of the diagnosis and treatment of the most common benign esophageal disorders in a concise and easy-to-read format.Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included and based both on evidence-based data and the experience of the most famous esophageal surgeons in the United States and abroad. Each chapter includes a summary of the current management strategy for the disease process, and a review of current state of the art techniques provided by world leaders on esophageal disease, surgeons and gastroenterologists alike. A special emphasis is given to emerging procedures in laparoscopy, thoracoscopy, and endoscopy. Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" is illustrated throughout with line diagrams that depict fundamental anatomic or technical principles and is a valuable resource for surgeons and gastroenterologists in residence and training.

Transplantation of the Heart and HeartLungs (N.E. Shumway). Physiologic Principles and Clinical Use of Hypothermia (L.K. Davis, R.F. Davis). Anesthetic Evaluation and Management in Bloodless Surgery (N.S. Faithfull). Normothermic Mycocardial Preservation, an Optimal Approach for Myocardial Protection During All Forms of OpenHeart Surgery (R.E. Engelman et al.). Pharmacologic Manipulations to Minimize Bloodloss in Cardiac Surgery (A.C. Cernaianu, A.J. DelRossi). Sutureless Intraluminal Ring Grafts for Aortic Replacement (G.M. Lemole). Immunologic Consequences of Transfusion (P.I. Tartter). Traumatic Rupture of the Thoracic Aorta (R.C. Camishion, J.B. Alexander). Cardiomyoplasty (R.C.J. Chiu). Current Status of Autotransfusion (R.A. Vertrees, A.C. Cernaianu). Transesophageal Echocardiology (W.H. O'Connor). The Use of Circulatory Support in Cardiac Surgery (R.L. Kormos). 9 additional articles. Index.

Benign esophageal diseases are common problems treated by thoracic surgeons.? This issue includes articles on the diagnosis and management of several motility and reflux disorders that are considered benign, with an emphasis on the use of cutting-edge technology.

A left ventricular assist device (LVAD) is a surgically implanted pump that helps the left ventricle pump blood to the rest of the body.? The purpose of this issue is to let cardiologists know about the latest devices, their complications, and the clinical situations in which they are most beneficial.

This is the first practice management issue ever published in Thoracic Surgery Clnics.? The purpose of the issue is to help thoracic surgeons with the day-to-day concerns involved in managing a surgical practice, including setting up and building a practice; billing, coding, and credentialing; administrative responsibilities; and retirement planning.

This issue of Clinics in Chest Medicine, guest edited by Robert Kotloff, focuses on the topics of Lung Transplantation. Articles include: Candidate Selection, Timing of Listing, and Choice of Procedure for Lung Transplantation; Lung Allocation in the United States, Selection and Management of the Lung Donor; Novel Approaches to Expanding the Lung Donor Pool: Donation After Cardiac Death and Ex Vivo Conditioning; Extracorporeal Life Support as a Bridge to Lung Transplantation; Survival and Quality of Life of Patients Undergoing Lung Transplant; Primary Graft Dysfunction; Acute Allograft Rejection: Cellular and Humoral Processes, and more!

This issue of Thoracic Surgery Clinics includes well-illustrated articles on surface anatomy, the pleura and pleural spaces (including the anatomy of the parietal and visceral pleura, the pleural reflections and recesses, and microscopic anatomy of the pleura), anatomy of the? mediastinum (including mediastinal divisions and compartments, the thymus, the superior vena cava and brachiocephalic veins, the heart and pericardium, the thoracic aorta and its branches, the thoracic duct, and the nerves of the thorax) and the anatomy of the diaphragm and the esophagus (including? vascular supply, lymphatic pathways, innvervation).

This issue of the Thoracic Surgery Clinics is dedicated to a technical aspect of the clinical practice with which surgeons have become increasingly familiar through the years. The term "chest wall surgery? refers to a wide variety of procedures, varying from a straightforward removal of one rib or the correction of a congenital malformation to an extremely complex resection and subsequent reconstruction of the chest wall primarily aimed at preserving geometrical and functional integrity. As such, chest wall surgery can really offer scenarios where the creativity and the technical skills are emphasized to an unprecedented level in the thoracic surgical practice.

This issue of the Thoracic Surgery Clinics will cover the following topics: physiology of pleural space, risk factors for prolonged air leak after pulmonary resection, surgical techniques to avoid parenchymal injury during lung resection, intraoperative measures for preventing air leaks, sealants and buttressing materials in pulmonary surgery, postoperative strategies to treat persistent air leaks, the management of chest tubes after pulmonary resection, digital and smart chest drainage systems to monitor air leaks, portable chest drainage systems and outpatient chest tube management, and prolonged air leak after LVRS and in the ventilated patients.

Proposed topics for this issue include: Anatomy and Physiology; Imaging; Paralysis -Acquired; Eventration; Posterior Hernias in Infants; Anterior Hernias in Infants; Congenital Hernias in Adults; Traumatic Hernias; Traumatic Hernias; Paraesophageal Hernias; Tumors; Reconstructive Techniques.

Proposed topics for this issue include: Preoperative Evaluation and Risk Assessment; Surgical Management of Benign Pulmonary Diseases; Surgical Resection for Lung Cancer in the Elderly; Benign Esophageal Diseases - Diagnosis and Treatment; Surgical Resection for Esophageal Cancer in the Elderly; Postoperative Pain Management in the Elderly; Chemotherapy in the Elderly - Induction and Adjuvant Therapy; Radiation Issues in the Elderly; Quality of Life Issues and Ethical Dilemmas in the Elderly; Areas of Future Research and Studies.

There are growing questions regarding the safety, quality, risk management, and costs of PCC teams, their training and preparedness, and their implications on the welfare of patients and families. This innovative book, authored by an international authorship, will highlight the best practices in improving survival while paving a roadmap for the expected changes in the next 10 years as healthcare undergoes major transformation and reform. An invited group of experts in the field will participate in this project to provide the timeliest and informative approaches to how to deal with this global health challenge. The book will be indispensable to all who treat pediatric cardiac disease and will provide important information about managing the risk of patients with pediatric and congenital cardiac disease in the three domains of: the analysis of outcomes, the improvement of quality, and the safety of patients.

The Epidemiology, Clinical features and Natural History of Emphysema; The National Emphysema Treatment Trial (NETT); 'Rationale and Experience for Staged Lung Volume Reduction Surgery' Rationale and Experience for Staged Lung Volume Reduction Surgery; Lung Volume Reduction Surgery for Non-Heterogenous Emphysema; Lung Volume Reduction Surgery for Alpha-1-Antripsin Emphysema; Concomitant Lung Cancer Resection and Lung Volume Reduction Surgery; Concomitant Cardiac Surgery and Lung Volume Reduction Surgery; Decision Making in the Management of Secondary Pneumothorax in Patients with Severe Emphysema; Intraoperative and Postoperative Management of Pulmonary Alveolar Air Leaks in Thoracic Surgery; Airway Bypass Treatment of Severe Homogenous Emphysema; Treatment of Heterogenous Emphysema Using The Spiration IBV Intrabronchial Valves; Treatment of Heterogenous Emphysema Using The Emphasys Zephyr EBV Endobronchial Valves; Update on Donor Assessment, Resuscitation and Acceptance Criteria; Update on Lung Transplantation for End Stage Emphysema

Utility of PET in the mediastinum; Diagnostic strategies for mediastinal tumors and masses; Infections of the mediastinum; Genetic markers of mediastinal diseases; Mediastinal tumors and cysts in the pediatric population; Multimodality treatment of germ cell tumors of the mediastinum; Surgical approaches to the thymus in patients with MG; Multimodality treatment of thymoma; Vascular lesions of the mediastinum; Combined cervico - thoracic approaches for complex mediastinal masses; Intraoperative strategy in patients with extended involvement of mediastinal structures; The role of surgical resection for locally recurring mediastinal tumors; Modern Radiotherapy for Mediastinal Disease; Surgery of the mediastinum -historical notes.

With the growing age of the population, the proportion of elderly patients with diffuse coronary artery disease and severe comorbidities is increasing. The characteristics of these patients render them unsuitable for currently recognized revascularization procedures (CABG, PTCA). Therefore, there is an urgent need for new treatment modalities which could alleviate their symptoms and increase blood flow to the ischemic myocardium, while being less invasive for their fragile condition. The aim of this book is to provide an anatomical and physiological background as well as a complete review of the alternative methods of revascularization which are under development, namely transmyocardial laser revascularization, therapeutic angiogenesis and neurostimulation.

This book focuses on how ventricular assist devices (VADs) can help provide destination therapy for patients with terminal heart failure, one of the most serious diseases in the world today because of the tremendous number of patients, the high mortality rate, and the cost of care. One means of providing cardiological support for patients suffering from heart failure is with VADs, and more than 10,000 patients worldwide have now been implanted with these devices. Half of them already have lived more than one year, and 2,000 patients more than two years, after surgery. This improved survival means that we have reached a point where VADs can be used for destination therapy, not just for bridge-to-recovery or bridge-to-transplant. In view of the increasing number of patients with advanced-stage heart failure and the availability and longevity of transplanted hearts, VADs can solve many problems. In addition to providing information about the devices themselves, this book includes vital guidelines on long-term management and support of VAD-implanted patients' everyday lives.

This book will provide both an evidence base and practical recommendations for the treatment of patients with congenital heart disease. It will be a resource to all health care providers, including pediatric cardiologists, pediatric intensivists, pediatric heart surgeons, fetal specialists, maternal fetal medicine specialists, neonatologists, nurses, advanced practice nurses, in addition to trainees in the field. It will summarize world knowledge on the topic of heart failure in patients with congenital heart disease. It will provide an in depth analysis of the current methods of diagnosis and treatment of heart failure. Now that surgical results are at record success rates, more patients with congenital heart disease are surviving, and thus at risk for sequelae from their disease, including heart failure. It will provide evidence based and practical recommendations to the practitioner for the management of heart failure signs and symptoms.

New Techniques for Thoracic Outlet Syndromes presents in a comprehensive format an up-to-date, state of the art reference that physicians can use in consultation to properly treat patients using the resources that modern medicine offers. This book offers the newer surgical approaches that have been developed during the past 30 years. Some of these techniques are modification of operations that were proposed previously but were not fully affective and left many patients suffering with permanent disability. This textbook is a compendium of the proper management of these patients that cannot be found in isolated reports of literature. The neurogenic-arterial thoracic outlet syndrome section covers how to diagnosis the illness using the proper tests, therefore eliminating the use of expensive, uncomfortable and inconvenient tests. The text is organized in three basic sections that cover all the aspects of the thoracic outlet syndromes. The first section addresses the neurogenic-arterial type, with the pertinent subsections: symptoms, diagnosis. A list of the useful tests is provided to make a correct diagnosis of this syndrome. This is followed by the sections on treatment, using the surgical approaches with historical aspects and evolution of the operations proposed. The second section involves the venous thoracic outlet syndrome divided into the corresponding subsections comprising: symptoms and physical findings, etiology, diagnosis. This section also includes a list of the usual tests to make the proper diagnosis. The last section of this text is dedicated to the presence of cervical ribs and their classification of the different types that occur, and also the proper surgical treatment when fusion of the upper ribs is present. New Techniques for Thoracic Outlet Syndromes offers the current, acceptable and most effective methods to handle thoracic outlet syndromes. It will be of great value to thoracic surgeons, vascular surgeons, interventional radiologists as well as fellows and residents in training for cardiothoracic and vascular surgery.

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, and one of the first to be successfully repaired by congenital heart surgeons. Although "fixed", patients born with tetralogy of Fallot cannot be considered "cured". Improving survival and quality of life for this ever-increasing adult population will continue to challenge the current and future generations of cardiologists. Adult patients with tetralogy of Fallot should be seen by a cardiologist specializing in the care of adults with congenital heart disease, to be monitored for late complications. They need to be checked regularly for any subsequent complications or disturbances of heart rhythm. This monograph is intended as both an introduction to the subject and a timely, comprehensive review, and will be welcomed by adult cardiologists, pediatric cardiologists, internists, surgeons, obstetricians, and intensivists who wish to learn about the most recent discoveries and advances concerning tetralogy of Fallot in adults. It will also be of interest to advanced undergraduates wanting to learn more about the subject.

This book represents the first comprehensive textbook devoted to the standard of care, current guidelines and innovations in the field of mesenteric vascular disease. The book reviews imaging modalities, diagnostic work up, physiologic tests, traditional open surgical techniques and novel endovascular approaches. Technical aspects of both open surgical and endovascular techniques are provided by experts in the field, with illustrations and photographs of key steps for each type of procedure. Results of epidemiologic studies and national databases are summarized, as well as large institutional experiences. An evidence-based approach is used for recommendations regarding best therapies. Diagnostic approaches including imaging and novel physiologic tests, including gastric tonometry and oxygen light spectroscopy are covered. Mesenteric Vascular Disease: Current Therapy will serve as a very useful resource for clinicians, surgeons, interventionalists, gastroenterologists and researchers dealing with and interested in mesenteric vascular diseases.

Therapeutic hypothermia has emerged as a very important treatment option for patients with cardiac arrest as it provides significant protection from developing neurologic injury once the patient has been successfully resuscitated. Studies have demonstrated over 15% absolute risk reduction in death and neurologic injury using this therapy. Although hospitals and medical centers have become familiar with this important intervention it still remains greatly under utilized due to an experience and lack of resources to safely and effectively deploy such a program. The objective of this book is to educate and familiarize both providers and institutions as to how to develop and deploy and provide therapeutic hypothermia to their patients. The current knowledge for this is provided by speakers and national experts and also by literature review. There are several courses being provided on this as well throughout the US. These are good venues for people to come and see and get hands on experience, but there still needs to be a concrete book with references on how to go about getting this program started.

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.

Cardiac performance is regulated not only by cardiac muscle properties but also by several other factors, including those associated with the neurohumoral system and the mechanical characteristics of the peripheral circulation. New information con cerning these regulatory factors has furthered our understanding of the pathophysi ology of cardiac dysfunction. However, controversy remains, along with a need to integrate these multidisciplinary findings. It was with this in mind, together with my continuing interest in the response of the normal and diseased heart to variations in loading conditions, that the satellite symposium entitled "Interactions Between Car diac Function and Vascular Dynamics" was organized and dedicated to my mentor, Dr. T. Takishima. The symposium was held in Fukushima, Japan, in 1992 following the Tenth Inter national Conference of the Cardiovascular Systems Dynamics Society in Kobe, Japan, which was organized by the then president of the society, Dr. Masatsugu Hori. The Fukushima symposium and the Kobe conference were stimulating and informative. To commemorate these events, Dr. Hori, Dr. Janicki, and I decided to publish this book. It covers topics that were presented then as well as pertinent new material. As a result, the book includes not only updated reviews but also up-to-date findings that were not considered at the two scientific sessions. The high level attained in this book is due to the outstanding contributions from internationally renowned scientists. This final product of their efforts should prove to be a valuable source of information to the reader.