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

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

Emergency General Surgery has become a cornerstone of Acute Care Surgery over the past decade. Once the scope of community general surgeons, the growing complexity of patients with acute surgical diseases has increasingly driven their care to tertiary referral centers. The aging population confounds this problem further as these patients present with more complex comorbidities, life-threatening physiology, and progressively severe anatomic disease severity. To ensure better outcomes, the practice has evolved to focus on evidence-based practice management guidelines in order to standardize care and optimize outcomes. The purpose of this text is to be a comprehensive volume for patients with acute surgical diseases. There will be three sections, each comprised of multiple chapters. The first section will be a comprehensive analysis of the background of Emergency General Surgery. The goal of this section will be to provide the reader background into the acute surgical practice and to introduce the reader to the important concepts discussed in the remainder of the textbook. The second section will be the largest and will discuss specific acute surgical diseases. Individual chapters will outline the diagnostic approach, current treatment standards, operative approaches, and expected outcomes with an emphasis on practice management guideline implementation into practice. As acute surgical diseases and surgical critical care are integral to each other, the last section will be Critical Care for the Acute Care Surgeon. These topics will focus on the critical care concepts essential to surgeons who care for acute diseases. This comprehensive text is targeted to any surgeon who takes emergency call for any of the listed diseases including community and referral general and vascular surgeons. In addition, this would be an excellent resource for all general surgery residents. Lastly, this would also serve as a resource to intensivists who care for acute surgical patients.

A comprehensive review the state-of-the-art in atherosclerosis of the arteries of the legs and feet. The authors discuss in detail the primary symptom-claudication-an intermittent pain in the leg or foot while walking, its predisposing factors, the current diagnostic methodologies, the impressive advances in the therapeutic armamentarium, and the need to screen for co-existing coronary artery disease. Additional chapters describe cutting-edge noninvasive angiography and vascular flow studies, specific drug therapy for claudication, regression of atherosclerosis therapy, gene therapy, and drug eluting stents for peripheral arterial disease. The authors also examine the epidemiology of LEAD, the effects of smoking and effective smoking cessation programs, its pathogenesis and its association with lipid abnormalities and hypertension, aggressive risk factor modification, and the need to measure the ankle brachial index of every patient over 45.

A comprehensive survey by leading basic and clinical researchers of the signal transduction mechanisms responsible for lung inflammation, including vascular hyperpermeability, white cell accumulation, and vascular remodeling. The authors cut across disciplines to bring together a broad-based presentation of inflammatory challenge, both in the initial phases of the inflammatory response, as well as in the more prolonged phase of genomic involvement. The book illuminates not only the processes of lung inflammation, but also the potential for developing new therapeutic strategies to combat inflammatory lung disease.

Bildgebung bei Erkrankungen des Lymphgefasssystems - Das Wichtigste fur alle AErztinnen und AErzte Erkrankungen des Lymphgefasssystems sind haufig, werden jedoch oft nicht erkannt oder in Ihrer Tragweite unterschatzt. Kenntnisse uber die diagnostischen Moeglichkeiten mittels bildgebender Verfahren sind selbst bei lymphologisch orientierten, aber auch in der Tumornachsorge tatigen AErztinnen und AErzten oft nur eingeschrankt vorhanden. Umfassend, praxisbezogen und anwendungsorientiert stellen die Autoren die bildgebenden diagnostischen Verfahren des Lymphgefasssystems, deren technische Durchfuhrung, Moeglichkeiten und Grenzen dar. Das Buch wendet sich an Facharztinnen und AErzte sowie AErztinnen und AErzte in Ausbildung, zu deren Fachrichtung Erkrankungen des Lymphgefasssystems gehoeren, also Allgemeinmediziner, Angiologen, Chirurgen, Dermatologen, Internisten, Lymphologen, Phlebologen. Aus dem Inhalt: Funktionelle Anatomie des Lymphgefasssystems Lymphszintigraphie/Funktionslymphszintigraphie Magnetresonanz-Lymphangiographie Indirekte Lymphangiographie und Direkte Lymphographie Sonographische Diagnostik der Lymphknoten und Lymphgefasse Sonographische Befunde bei OEdemen und Lymphoedemen und anderen interstitiellen Flussigkeitseinlagerungen Zystische lymphatische Malformation (LM) - Diagnose und Therapie Indocyaningrun (ICG)-Lymphographie in der Lymphchirurgie Nuklearmedizinische Wachterlymphknoten-Diagnostik Positronenemissionscomputertomografie (PET) - Detektion pathologischer Lymphknoten Fluoreszenz-Mikrolymphographie - eine wichtige Methode zur Fruhdiagnose des Lymphoedems

The concept for this book evolved over many years of intense clinical practice during which a wide variety of vascular complications were encountered as a result of other surgical or interventional procedures. In this book, the authors describe cohesive efforts by experts in the field as they commit to advancing health care quality by all professionals. It should be noted at the outset that the book does not discuss various non-vascular or systemic complications of patients undergoing vascular interventions such as myocardial infarction, renal or respiratory failure. Instead, the content is divided into four separate sections. The material begins with an introduction to vascular anatomy and function. There follows a section addressing specific complications of the vascular system that can occur in any patient, sometimes even without intervention. The third section addresses complications specific to interventions and surgical procedures. The final section is dedicated to the delayed and long-term sequelae attributable to the most commonly encountered vascular complications. Vascular Complications of Surgery and Intervention: A Practical Guide is targeted towards dedicated health care professionals managing patients affected by inadvertent but potentially disastrous vascular complications and for those practitioners performing interventions either directly upon the vascular system or procedures that have potential for collateral impact.

The go-to resource for managing a full spectrum of clinical scenarios in acute ischemic stroke Ever-evolving technological advances have created a daunting number of emergent neurointerventional protocols and therapies for treating acute ischemic stroke. This has created an urgent need for reader-friendly, hands-on resources. Video Atlas of Acute Ischemic Stroke Intervention edited by renowned neuroinventional stroke experts Maxim Mokin, Elad I. Levy, Adnan H. Siddiqui, and esteemed contributors fills a void in education and knowledge with interactive, case-based guidance on mastering challenging stroke interventions. The atlas leverages current knowledge and decades of experience in acute stroke treatment and device innovations to familiarize clinicians at various career stages with a wide repertoire of techniques available in the neurointerventional suite. The book focuses on technical aspects of interventional stroke procedures including pitfalls and complications, an overview of the most useful tools of the trade, and discussion of pre- and post-procedural care. Eighteen chapters provide comprehensive coverage on the most common endovascular treatment approaches for acute stroke—aspiration and stent-retriever thrombectomy of proximal, distal, and tandem occlusions. Several cases focus on recognition and management of complications that clinicians may encounter during emergent procedures. Topics include the importance of arterial access, unmet need in current devices, and methods for overcoming these challenges. Key Highlights Thirty-eight individually narrated, high-definition videos describe angiographic and procedural cases, step by step High-quality illustrations emphasize and delineate key aspects of complex procedures Firsthand tips and tricks enhance the ability to manage highly challenging and less common pathologies, including arterial dissection, atherosclerosis, and venous strokes This must-have resource will benefit all practitioners involved in the interventional care of patients with acute ischemic stroke. This book includes complimentary access to a digital copy on https://medone.thieme.com.

The need for dialysis access surgery is growing rapidly as the population of patients with end stage renal failure expands. This book is aimed at those healthcare professionals involved in the care of patients undergoing dialysis. "Vascular Access Simplified" gives a comprehensive review of all aspects of adult dialysis access with a specific emphasis on haemodialysis. The text highlights some of the difference in practises of physicians in Europe and the USA. The contributors are allied professionals, physicians, radiologists, vascular and transplant surgeons who have a specific interest and are all committed to improving the quality of dialysis access. The approach of each chapter is essentially practical with a few chosen references to aid further study rather than an exhaustive bibliography.

This volume is particularly valuable as a current standard reference. It covers all the major vascular operations - carotid endarterectomy, aortoiliac reconstructions and infrainguinal bypasses (in-situ and reversed vein, Dacron and PTFE prosthetic), thoracic and abdominal bypasses - matching each to its competing endovascular procedure. In addition, it provides excellent long-term data on such less common procedures as internal carotid bypass, vertebral artery revascularization, adjunctive procedures to enhance the patency of infrainguinal prosthetic bypass, and percutaneous intentional extraluminal revascularization. Finally, this framework is reinforced by in-depth chapters on current non-interventional management, surveillance programs to enhance long-term patency, and the ultimate challenge for all practicing vascular surgeons - the management of infected aortic grafts. Such clear, comprehensive, and current analysis should be of considerable and on-going value, both by helping vascular surgeons to make more effective decisions and to more knowledgeably discuss functional results, complication risks, life expectancy and surgical outcome issues with the patient and family.

Challenging Concepts in Interventional Radiology is a cased based guide to the most challenging aspects of interventional radiology and endovascular procedures. The 31 Cases have been selected to cover a wide-spectrum of scenarios, from the endovascular repair of thoracic and abdominal aortic aneurysms to the ablation of lung and kidney tumours. Cases are examined from a multidisciplinary approach with consideration of diagnosis, practical procedures, evidence base, and guidelines. Case commentaries from renowned experts in the field provide a useful and high level narrative across each case and compliment the clinical tips and evidence provided throughout. The collaboration of authorship between trainees and experts provides a unique insight into the management of the most complex and important cases in the radiology field. With a highly user friendly format, the textbook provides clinical tips and expert commentary for easy use in every day clinical practice. Suitable for candidates for the European Board of Interventional Radiology exam, fellows of Interventional Radiology, British Society of Endovascular Therapy fellows and radiologists, Challenging Concepts in Interventional Radiology appeals to a wide-ranging level of radiologists.

Part of the Neurosurgery by Example series, this volume on cerebrovascular neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within cerebrovascular neurosurgery, including aneurysms, ischemic/occlusive disease, arteriovenous malformation, dural arteriovenous fistula, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Cerebrovascular Neurosurgery is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

Moving beyond the science of hemodialysis access, this collection of clinical cases covers procedural and practical aspects of arteriovenous fistula, arteriovenous graft, dialysis catheter, draining veins, central veins, arterial interventions and hand ischemia. World experts in the disciplines of interventional nephrology, interventional radiology and surgery offer creative visions of their practice and provide insights on topics from routine access creation to advanced novel techniques. Dialysis Access Cases presents solutions to problems encountered in practice while capturing the art of this medical discipline and challenging procedure.

Endovascular intervention - using medication and devices introduced through catheters or microcatheters placed into the blood vessels through a percutaneous approach - has emerged as a relatively new minimally invasive approach to treat cerebrovascular disease and possibly intracranial neoplasms. This textbook provides a comprehensive review of principles pertinent to endovascular treatment of cerebrovascular diseases and intracranial tumors, with a detailed description of techniques for these procedures and periprocedural management strategies. Particular emphasis is placed on expert interpretation of the quality of evidence provided and implications for practice related to endovascular procedures. This will be essential reading for clinicians working in interventional neurology and cardiology, endovascular neurosurgery, vascular surgery and neuroradiology.

Die Mikrogefasschirurgie spielt bei Gewebetransplantationen eine immer groessere Rolle. Dieses Buch ist ein "Gewusst-wie"-Text uber die mikrovaskulare Rekonstruktionschirurgie, das vorwiegend von einem einzelnen Chirurgen geschrieben wurde. Es richtet sich sowohl an den erfahrenen als auch an den noch in der Ausbildung befindlichen Chirurgen. Das Buch ist in zwei Abschnitte gegliedert. Der erste beschreibt die operative Anatomie und Technik, die mit der Hebung jedes freien Gewebetransfers verbunden ist. Der zweite Teil behandelt die Anwendung dieser Transplantate fur die Rekonstruktion in drei anatomischen Regionen, in denen die rekonstruktive Mikrochirurgie bedeutende Ergebnisse geliefert hat: Kopf, Hals sowie obere und untere Extremitat. Das Buch ist ein aktuelles Nachschlagewerk fur jeden auf diesem Gebiet arbeitenden Chirurgen, Orthopaden und Traumatologen.

The aim of this book is to help clinicians to reduce the risk of complications after vascular and endovascular surgery. Whilst it is a surgical truism that the surgeon who does the most operations has the most complications (an acknowledgement of the fact that all vascular and endovascular procedures are potentially hazardous, and some extremely so), some surgeons seem to have more complications than others. This book is for all surgeons and radiologists who accept the challenge continually to improve their results. Each chapter is authored by an experienced (endo)vascular specialist who will have witnessed firsthand the perils and pitfalls of vascular procedures. They have seen all the complications, and even occasionally made errors of judgement. The chapters are full of information to help the reader avoid similar hazards in future. We live in a world of high patient expectation, where complications are seen as 'someone's fault'. Clinicians are familiar with innovations such as outcomes audit and assessment, procedural governance and quality improvement programmes. There is pressure to show progressive improvement. First class surgery is a combination of knowledge and skill and perhaps just a little luck, though as is oft quoted 'the more you practice, the luckier you get'. The information in this book will provide insights, protocols, and tips and tricks to minimise the risks of procedures in vascular and endovascular surgery. It is therefore essential reading for anyone who treats patients with vascular disease.

In this era of evidence-based medicine, clinicians treat common conditions according to guidelines and protocols derived from the results of randomised clinical trials. This book will help vascular specialists when they have to treat a patient with an unusual condition where they may have no experience and there is little published scientific information. The Joint Vascular Research Group has collected rare vascular conditions in a register for over a decade, and this book reviews the experience, together with the best information from the surgical literature. The authors give a practical guide on the diagnosis and management of rare vascular disorders. This book should be read by everyone who manages patients with vascular disease.

G. Carstensen Die Chirurgie ist eine Wissenschaft, ihre Ausubl, mg ein Handwerk; sie verlangt eine UEbereinstimmung logischer, handwerklicher und intuitiver Vorgange, wobei der Kopf die Hand leitet. Wissenschaft ist nicht nur der jeweilige Stand unserer Er- kenntnisse, sondern auch unserer Irrtumer - allerdings mit der Einschrankung, dass der Irrtum von heute der Fortschritt von morgen sein kann und unsere Fahigkeiten, Entwicklungen vorauszusehen, nicht uberschatzt werden sollten. Eine Wissenschaft hutet als wertvollstes Gut, was sich nach Bewahrung durchge- setzt und als Bestand erwiesen hat. Diesem Ziel dienen unsere Tagungen, die auch Auskunft uber neue Entwicklungen oder sich abzeichnende Ergebnisse zu erteilen haben. Ausserdem verlangt die wissenschaftliche Halbwertszeit des Arztes nach standiger Erneuerung und Erganzung des Wissens. Chirurgischer Fortschritt grundet sich nicht zuletzt auf die Erkennung und Ver- meidung intra-und postoperativer Komplikationen, deren Eroerterung auf unseren Kongressen und im Schrifttum meist zu kurz gerat, weil verstandlicherweise lieber vom Erfolg geredet wird. Jedoch, das Kriterium und Gutezeichen chirurgischer Ar- beit ist die Sicherheit des Eingriffs, und zwar in der Indikation wie in der operativen Durchfuhrung. Diesem Buch und seiner Sammlung sei daher ein Wort von Rudolf Nissen vorangestellt: Es tut allen, den Jungen wie den Alten, gut, immer wieder daran erinnert zu werden, dass Unvollkommenheit der Leistung unser tagliches Schicksal und dass ih- re klare Erkenntnis der beste Weg ist, sie zu vermeiden.

Dieser Band behandelt schwerpunktmassig den Stellenwert neuer diagnostischer Methoden und Therapiestrategien in Kardiologie und Kardiochirurgie.
Die einzelnen Beitrage unterziehen sowohl Neuentwicklungen als auch Etabliertes auf dem Sektor Diagnostik und Therapie in beiden Disziplinen einer kritischen Wurdigung hinsichtlich ihres Nutzens und Fortschrittes fur die Lebensqualitat und Prognose der Patienten. Es wird ersichtlich, wie wichtig eine enge Kooperation zwischen Kardiologen und Herzchirurgen ist, um die durch den Fortschritt neu definierten Zielsetzungen verwirklichen zu konnen.
Angesichts der Kostensteigerungen im Gesundheitssystem und andererseits knapper werdender finanzieller Resourcen, ist ein weiterer Schwerpunkt auch den soziookonomischen Bedingungen der universitaren High-Tech-Medizin gewidmet. So wird in den Beitragen das derzeit medizinisch Machbare auch immer einer Kosten-Nutzen-+Analyse unterzogen."

Die Gefasschirurgie wandelt sich. Neue Verfahren scheinen Altbewahrtes abzuloesen. Die medizinischen Strukturen erfahren entsprechende AEnderungen. Ist eine Kooperation zwischen der Gefasschirurgie und der Interventionellen Radiologie moeglich? Im Juni 1997 trafen sich namhafte Spezialisten auf dem Kongress fur Gefasschirurgie am AK Hamburg-Harburg. Neben einer Bestandsaufnahme der gegenwartigen Situation und ihren empirischen Wurzeln, wurden Perspektiven fur die Zukunft der Gefasschirurgie vorgestellt und diskutiert.

Einerseits sind Chirurgen, Kardiotechniker und Intensivmediziner mit einer rasanten Weiterentwicklung von Kreislaufassistenzsystem konfrontiert, andererseits mit der standigen Optimierung etablierter Verfahren der Herz-Lungen-Maschinen-Chirurgie. Die Themenbereiche des vorliegenden Buches sind: - Intraaortale Ballongegenpulsation - Extrakorporale respiratorische Unterstutzung - Ventrikulare Pumpsysteme Es bietet dem Leser eine aktuelle Information uber den jeweils gegenwartigen Entwicklungsstand sowie eine Standortbestimmung."

Infolge verbesserter diagnostischer und therapeutischer Moglichkeiten und der Zunahme der durchschnittlichen Lebenserwartung steigt die Zahl der Patienten mit terminaler Herzinsuffizienz weltweit dramatisch an. Die Herztransplantation als etablierte Therapie allein ist nicht in der Lage, dies zu kompensieren. Daher besteht die dringende Notwendigkeit, neue Behandlungsstrategien zu entwickeln.

Mit den heute zur Verfugung stehenden Unterstutzungssystemen stehen wir an der Grenze zwischen "bridge-to-transplant" und "chronical support." Das vorliegende Buch bietet einen Uberblick uber die etablierten Systeme zur Behandlung der Herzinsuffizienz, aber auch eine erste Orientierungshilfe bei alternativen Verfahren, die sich noch in einem experimentellen Stadium befinden."

Neben den Grundlagen zum Thema "Akuter Extremitaten-Arterienverschluss" werden in diesem Band auch Erfahrungen mit neueren Methoden, wie z. B. der angioskopisch kontrollierten Ebolektomie und der intraarteriellen Lyse verschlossener femoro-distaler Bypasse, dargestellt. Dieses Buch ist damit eine Erganzung grosserer und umfassenderer Werke. Auch einige akute Verschlusse seltener Ursachen, wie Ergotismus, akute Aortendissektion und heparininduzierte Thrombozytopenie sind mit aufgenommen. Letztere sind differenzialdiagnostisch ausserordentlich wichtig, da man bei der Behandlung eines akuten Arterienverschlusses unter Zeitdruck steht, um eine "restitutio ad integrum" zu erreichen."