In the dark years of apartheid, a boy grew up in a household with a terrible secret: although they were all of mixed origins, they had managed to `pass as white'. Young Winston Wicomb, however, was far too dark to fit in, and had to be hidden whenever someone knocked on their door. After struggling through school and even managing to obtain an university degree, he still remained unemployed due to his skin colour. To make ends meet, he serviced cars in their backyard, but never stopped dreaming about escaping the restraints of Apartheid. Then fate intervened. While distributing pamphlets advertising his mechanical skills, he found Professor Chris Barnard stranded next to the road. He offered to help even though he had no experience with the new Mercedes the professor drove. Barnard, surprised at the success of Winston's efforts and impulsive as ever, offered Winston a job in his research lab. It is here that Winston applied his knowledge and experience of matters mechanical to eventually produce the world's first apparatus to transport a living heart over long distances. `Vital Remains' tells to story of an unlikely hero, a huge risk, achievement ... and love.

This book is intended as a comprehensive, practically oriented reference on pulmonary hypertension within the context of adult congenital heart disease (ACHD). After an introductory chapter on pathophysiology, the various types of pulmonary hypertension that may be encountered in ACHD are discussed, highlighting the specifics observed within different patient categories. The diagnostic approach is then addressed in detail, and the last section of the book is devoted to management options, from conservative approaches to interventional treatment and the concept of treat and repair. Management in specific patient subjects, such as pregnant women, Fontan patients, and Down syndrome patients with Eisenmenger syndrome, is fully discussed, and guidance is also provided on palliative care. Pulmonary arterial hypertension related to congenital heart disease (PAH-CHD), despite significant similarities in lung pathohysiology, differs significantly from other types of PAH in terms of mechanism of onset, natural history and management. Mistakes and pitfalls in the management of patients with PAH-CHD are often related to a lack of knowledge or expertise in this condition. Pulmonary Hypertension in Adult Congenital Heart Disease will be a valuable resource and learning tool for all who care for patients with ACHD, both in tertiary practice and general cardiology.

Nearly all of us will, at some point, know someone who was born with a heart defect. But, as the surgical scars so often remain hidden, we just might not realise it.; Powerfully telling of the patients and their experiences, Open Hearts is a remarkable medical story: we are often so focused on 'extraordinary' people and their achievements, we forget just how incredible the 'ordinary' achievements of living can be.; Until the 1960s 'blue babies' were a striking sight in our streets. Suffering from congenital heart disease offered a bleak outlook to young patients and a heartbreaking experience for parents. Very few would make it to adulthood; now, in the West at least, most have a much higher chance of survival.; In Open Hearts Kate Bull, formerly a cardiologist at Great Ormond Street Hospital, tells not just of the development of heart surgery in children, but of the patients, past and present, whose lives have been transformed. Besides the technology, the sociology of medicine has changed substantially since the 1950s - think of the atmosphere of children's wards.Other things have barely changed - consider the dread of kissing your child goodbye at the door of an operating theatre in any era. ; Children's heart surgery is often seen as a medical triumph; but, for all the successful operations completed, thousands of pioneering patients have gone before, perhaps facing their own uncertain futures. Today, we place great hope in the power of science. Many lives have been saved; but, sometimes, we ask medicine to do more than it can.; By turns frightening, heart-wrenching and inspiring, Open Hearts is a powerful story of medical progress, hope and survival.

Following the success of its last symposium and book entitled 'The Evidence for Vascular Surgery', the Joint Vascular Research Group (JVRG) brings you this book. The book describes recent developments and best practice in vascular surgery, with an emphasis on multi-disciplinary care pathways. It is based upon a symposium held in Sheffield in June 2002 that aimed to improve the provision and equality of care for patients with peripheral arterial and venous disease. Many members of the JVRG have contributed to this book, including vascular surgeons, anaesthetists, radiologists, nurses and vascular technologists. The book consists of five sections covering the main areas of management of patients with peripheral vascular disease: Outpatients and medical management; Vascular imaging and endovascular intervention; Vascular surgery; Anaesthesia and theatres; Organisational aspects of care.

This book summarizes the branch tracing method for bronchoscopic diagnosis. Cytopathological and histopathological diagnoses are essential to making prognoses and selecting appropriate treatment for peripheral pulmonary lesions, notably lung cancer. In order to collect cell and tissue samples from peripheral pulmonary lesions for cytopathological and histopathological diagnoses, exfoliative cytodiagnosis and biopsy under bronchoscopy with endobronchial ultrasonography (EBUS) are currently used worldwide. Bronchial Branch Tracing highlights how to identify the bronchial branches that lead to peripheral pulmonary lesions and offers a valuable guide for all respiratory physicians, as well as surgeons, who frequently perform bronchoscopies, helping them understand the method and improve their technique.

Ein umfassender Leitfaden zur richtigen Planung, Programmierung und Implementierung heutiger Schrittmacher und anderer Herzimplantate, inkl. Problemloesungsstrategien. Dieses praktische Nachschlagewerk fuhrender Ausbilder im Klinikbereich richtet sich an angehende AErzte und Klinikmitarbeiter, die uber keine oder wenig Erfahrung in der Programmierung und dem Management von Implantaten verfugen. Best-Practice-Informationen sind in ein Referenzwerk geflossen, das sich auf die wichtigsten Schritte, haufige Fehlerquellen und moegliche Komplikationen konzentriert. Jedes Kapitel ist auf die Praxis ausgerichtet und gibt Handreichungen, um auch schwierigste, geratebezogene Aufgaben, wie Programmierung und zielfuhrende Problemloesung bei Komplikationen, schnell zu meistern. Die heutigen Schrittmachen und EP-Gerate sind im Vergleich zu fruheren Entwicklungen das, was Smartphone und Telefone mit Wahlscheibe gemein haben. Sie sind nicht nur kleiner und fur den Patienten komfortabler, sondern bieten auch komplexe Programmieroptionen, die es Klinikern ermoeglichen, Gerate ganz individuell auf die Anforderungen der Patienten anzupassen. Je kleiner, intelligenter und anpassbarer die Gerate werden, desto groesser sind die Herausforderungen fur Kliniker in puncto Konfiguration, Management und UEberwachung. Mit dieser einzigartigen Kurzreferenz lasst sich diese wichtige Technologie viel einfacher handhaben. AErzte und Techniker erhalten genau die Informationen, die sie benoetigen. - Konzentriert sich auf die Aufgaben, die Kliniker durchfuhren, inkl. der Schritte vor der Implantation, Planung, Programmierung, Management, Problemloesung etc. - Zeigt anhand von Beispielen aus der Praxis, wie Experten im klinischen Umfeld optimale Ergebnisse im eigenen Labor erzielen. - Bietet mehr als 300 Fotos, einschliesslich EKG-, Roentgen- und Fluoroskopie-Aufnahmen, Bilder von Gerateabfragen, intrakardiale Elektrogramme sowie farbige elektroanatomische Maps. - Begleitende Website mit Videos zu allen wichtigen Aufgaben und Verfahren.

Die Entwicklung neuer Materialien und Techniken ftir die Gefass- chirurgie hat den Horizont der gesamten Chirurgie in ungeahnter Weise erweitert und befruchtet. Stand fruher im wesentlichen die sachgemasse Versorgung von Gefassen im Vordergrund, so bieten sich heute zahllose Moeglichkeiten einer Rekonstruktion der Blut- strombahn und daruber hinaus der Schaffung neuer Blutwege bis hin zum Anschluss transplantierter oder kunstlicher Organe. Kein Zweig unseres Faches ist hiervon ausgeschlossen. Wenn sich auch besondere Schwerpunkte der Gefasschirurgie entwickelt haben, so muss doch jeder Operateur zumindest die sein eigenes Interessen- gebiet betreffenden Gefasseingriffe beherrschen. Insofern mutet der hier und da geausserte Alleinvertretungsanspruch ftir die gesamte Gefasschirurgie kurios an. Viele Chirurgen sind von dieser sturmischen Entwicklung uber- holt worden, wahrend andere mangels Weiterbildungsmoeglichkei- ten oder eines geeigneten Krankengutes Muhe haben, diesen Fort- schritt mitzuvollziehen. Diese Hemmnisse zu uberwinden, hat sich der Autor ausdrucklich zum Ziel gesetzt. Die Gefasschirurgie -wie jede andere operative Tatigkeit -steht auf drei Saulen. Einmal muss der gegenwartige Stand des Wissens uber die Moeglichkeiten und Grenzen der Gefasschirurgie vorhan- den sein. Dann gilt es, die im Grunde einfachen, wenn auch durch besondere Sorgfaltspflicht gezeichneten Methoden der atraumati- schen Handhabung von Gefassen und deren Naht zu erlernen und schliesslich muss der Zugriff zum Gefasssystem "sitzen", das heisst, eindeutig, zweckmassig und schonend sein. Diesem letzteren Ziel dient dieses Werk.

Das klinische Wissen zu den Erkrankungen der Gefasse und zur invasiven Gefasstherapie ist umfassend und detailliert in diesem Buch zusammengefasst - eine unerschoepfliche Informationsquelle fur jeden operativ, interventionell oder konservativ tatigen Gefassspezialisten! Der aktuelle Kenntnisstand zu den physiologischen und pathophysiologischen Grundlagen ist ebenso dargestellt wie die modernen diagnostischen und therapeutischen Verfahren. Den Schwerpunkt bilden die Kapitel, in denen alle systemischen und regionalen Erkrankungen der Gefasse ausfuhrlich beschrieben werden. Auch seltene Erkrankungen und Konstellationen sind berucksichtigt. Fur jede Indikation werden die Therapieoptionen sorgfaltig abgewogen und konkrete Empfehlungen zum praktischen operativen und interventionellen Vorgehen gegeben. In der 2. Auflage wurden die Kapitel durchweg aktualisiert und zum Teil komplett neu verfasst: * neben Experten aus dem deutschen Sprachraum wurden fur einzelne Themen auch internationale Spezialisten als Autoren gewonnen. * zusatzliche Kapitel zu diagnostischen Verfahren (wie PET/CT), therapeutischen Methoden (wie allogene und xenogene Materialien) und klinischen Fragestellungen (wie Portanlage und PICC, Damage Control Surgery bei Gefassverletzungen und intestinale Aneurysmen) wurden erganzt. Parallel zur gedruckten Ausgabe erscheint erstmals eine online-Version, die als Live Reference-Ausgabe kontinuierlich aktualisiert wird.

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.

The sixth edition of this acclaimed and established operative atlas continues to provide a unique level of comprehensive detail on operative surgery of the heart and great vessels.With an international list of authors, the chapters have been updated and complemented by the same high quality artwork that has established this operative guide as the gold standard reference for the cardiac surgeon. This new edition retains the format of initial principles and justification for the procedure, followed by preoperative investigations and preparation, the operative procedure, and postoperative management. New chapters have been added on the latest techniques such as minimal invasive surgery, robotic surgery and off-pump bypass surgery.The chapters are arranged in seven sections, with each section emphasising the overall management of patients, tricks of the trade of individual authors and discussion of technical and clinical judgement. With this new and updated edition, Operative Cardiac Surgery remains the pre-eminent operative guide to a full range of cardiac conditions.Video clips of cardiac procedures, both common and rare, are included within the VitalSource edition.

This book looks at specific vascular surgery questions that have arisen and where careful analysis is given according to the level of supporting evidence available. As new technology is introduced to treat the cardiovascular system, alternative therapies begin to challenge and also complement traditional vascular surgery. All chapters contain the PICO table to summarise specific characteristics relative to the questions posed in each chapter. Difficult Decisions in Vascular Surgery- An Evidence-Based Approach is a current and timely reference source for practicing surgeons, surgeons in training, and educators, that describes the recommended ideal approach, rather than customary care, in selected clinical situations.

This new edition is an integral source of information on Atherosclerosis. It covers topics such as newer coronary risk factors, high-density lipoprotein metabolism, lipid-lowering drugs, endothelium and thrombosis in atherogenesis, and contributing risk factors. With over 500 exceptional photographs, diagrams, and charts, each chapter illustrates an important facet of diagnosing and treating this common and often fatal disease.

The conventional chest x-ray remains the first line in the diagnostic imaging of thoracic disease. In the new edition of this classic, you will get the essential help you need to make preliminary diagnoses of a vast range of pulmonary, cardiovascular, and other thoracic conditions. The differential diagnostic information is provided in extensive tables, organized by classes of findings, and illustrated by hundreds of brilliant radiographs and, where helpful, schematic diagrams. Professionals value the systematic structure of the information in the Burgener series, which aids in making diagnoses confidently and cost-effectively.

Das vorliegende Buch soll uber Risiken der herzchirurgischen Operation und des Patienten aufklaren und zu deren Optimierung beitragen.

Herzchirurgische Eingriffe werden heute bei adaquater Indikation mit geringerem Risiko durchgefuhrt als grosse Eingriffe in anderen Disziplinen. Gleichzeitig zeigen die weiter hohe Morbiditat und Mortalitat von Herzerkrankungen auf, dass die Kenntnis des Therapieangebots bei vielen, die diese Informationen benotigen um entsprechende Schritte einzuleiten, noch nicht gegeben ist. Stattdessen werden Patienten und Zuweiser von Hypothesen und Annahmen in ihrer Entscheidung beeinflusst.

Die Darstellung der Moglichkeiten transparenter Qualitatssicherung soll helfen, solche Informationsdefizite zu beseitigen und mit Hilfe serioser Bewertung qualitativ hochwertiger Behandlungsergebnisse die oft verzogerte Indikation zur operativen Behandlung zu vermeiden.

Weiter werden Bedeutung wie Begrenzung des Benchmarkings hinsichtlich der Qualitat herzchirurgischer Operationen verdeutlicht."

What is the evidence? Evidence-based medicine, or EBM which slips off the tongue more readily, seeks to offer proof that what we offer patients whenever we treat them, do a diagnostic test, or recommend anything from an operation to change in life style, is known to be effective. Fifty to 100 years ago, health care was delivered patchily, much less of it was effective, and was based on an image of a kindly doctor treating the sick, who were glad of whatever help could be offered. Now, medicine is effective and whether you look at it as major government expense or big business in private health care insurance, there is no sense in spending money on ineffective treatments, while we do not have enough to spend on what is of proven worth. Individual doctors cannot read everything and cannot possibly synthesise what they do read, so that they are aware of what is proven to be effective and what probably is not. The "The Evidence for ..." series seeks to fill that need. Into "The Evidence for Cardiothoracic Surgery" we have commissioned systematic reviews of the common operations and some innovative treatments, to present the facts to busy doctors. Where is there and where is there not evidence?

This book provides an overview of current and potential applications of artificial intelligence (AI) for cardiothoracic imaging. Most AI systems used in medical imaging are data-driven and based on supervised machine learning. Clinicians and AI specialists can contribute to the development of an AI system in different ways, focusing on their respective strengths. Unfortunately, communication between these two sides is far from fluent and, from time to time, they speak completely different languages. Mutual understanding and collaboration are imperative because the medical system is based on physicians' ability to take well-informed decisions and convey their reasoning to colleagues and patients. This book offers unique insights and informative chapters on the use of AI for cardiothoracic imaging from both the technical and clinical perspective. It is also a single comprehensive source that provides a complete overview of the entire process of the development and use of AI in clinical practice for cardiothoracic imaging. The book contains chapters focused on cardiac and thoracic applications as well more general topics on the potentials and pitfalls of AI in medical imaging. Separate chapters will discuss the valorization, regulations surrounding AI, cost-effectiveness, and future perspective for different countries and continents. This book is an ideal guide for clinicians (radiologists, cardiologists etc.) interested in working with AI, whether in a research setting developing new AI applications or in a clinical setting using AI algorithms in clinical practice. The book also provides clinical insights and overviews for AI specialists who want to develop clinically relevant AI applications.

This extensively revised edition is an essential reference for physicians involved in the diagnosis, referral and treatment of the thoracic outlet syndrome (TOS). TOS is made up of a constellation of problems resulting from pathology at the thoracic outlet in the neck. Busy specialty practice sees multiple affected patients in every clinic, but TOS can often be difficult to diagnosis. Thoracic Outlet Syndrome explores all possible ancillary care issues surrounding this complex condition, including rehabilitation, disability, natural history and medicolegal issues, and aims to stimulate research, discussion and a sense of community between professionals involved in this area. Vascular and thoracic surgeons, neurosurgeons, neurologists, psychiatrists and psychologists, physical therapists, occupational medicine specialists and pain specialists will find this book a must read for successful treatment, referral and diagnosis of TOS in clinical practice.

This book spans topics in both congenital and acquired right heart disease providing readers with detailed information on the physiology, anatomy and myocardial mechanics of the right ventricle (RV), while describing the use of echo and MRI imaging to diagnose, and new developments in surgery and cardiac catheterization to treat. Right Ventricular Physiology, Adaptation and Failure in Congenital and Acquired Heart Disease includes extensive discussion of RV-pulmonary interactions, pulmonary hypertension and ventricular-ventricular interactions, including specific topics in embryology, fetal RV function, RV mechanics, pathophysiology of RV adaptation/ failure, molecular aspects of RV dysfunction, congenital heart disease, pulmonary arterial hypertension, pulmonary valve replacement, stem cell and future therapies. It is thus important reading for all cardiovascular medicine professionals, but especially pediatric cardiologists and surgeons, those who manage t hese patients in the cardiac care unit and investigators studying the RV.

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.

Fundamentals of Congenital Minimally Invasive Cardiac Surgery is a first of its kind, fully-illustrated guide that is solely dedicated to the most diffused congenital minimally invasive cardiac surgery procedures. It provides detailed, step-by-step descriptions of surgical maneuvers to underline each aspect of the procedures along with full color drawings and operative pictures to enhance understanding. Each chapter fully describes the preoperative setting, the needed materials and the required technical skills that make specific congenital heart defects amenable to minimally invasive surgical treatment. This is the perfect go-to reference for pediatric and congenital cardiac surgeons, and is also a must-have guide for residents in cardiac surgery who are looking to review the technical aspects and outcomes of utilizing a minimally invasive approach for cardiac surgery.

The dramatic race to transplant the first human heart spanned two years, three continents and five cities against a backdrop of searing tension, scientific brilliance, ethical controversy, racial strife and emotional turmoil. It culminated in a terrifying moment in the early hours of 3 December 1967 when, in a cramped operating theatre in a Cape Town hospital, Professor Chris Barnard stared into an empty cavity from which he had just removed a heart. He knew that he had only minutes left to make history and save the life of a 55-year-old man by filling the gaping hole in his chest with a heart which had just been beating inside a 25-year-old woman. Every Second Countsis the story of this gripping race to conquer the greatest of medical challenges. It also reveals the truth about the man at the centre of it all, whose turbulent life story was just as gripping. The kind of true story that would be dismissed as far-fetched if presented as fiction, it combines an utterly compelling portrait of cutting-edge science with raw human drama, and shows how the course of medicine itself was changed for ever.