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Mechanical cardiovascular assist devices must be properly designed
to avoid damage to the blood they contact. The factors that affect
the hemocompatibility of a cardiovascular assist device include
three major non-physiological components - the material, fluid flow
paths, and flow related stresses, - as well as the device
interaction with the native vasculature. Furthermore, the
interaction of the device with the blood is not static. Foreign
surfaces activate blood components including platelets, leukocytes
and the coagulation cascade. Thrombus formation on the surface of
the device can alter the fluid dynamics in a manner that causes
erythrocyte damage ranging from significant hemolysis to sub-lethal
trauma that can take many days to weeks to develop into a
significant clinical problem. This sub-lethal blood trauma is not
easily detectable without special equipment, which is typically
unavailable in routine clinical practice. Surveillance for blood
damage is often sub-optimal in the clinical setting, but once
clinically relevant hemolysis occurs, crucial decisions - device
removal, replacement, or additional medical therapies including
surgery or plasmapheresis - that take into account the risk/benefit
of intervention must be quickly evaluated. The various preclinical
designs and testing, surgical considerations, available
surveillance techniques, and clinical consequences will be
discussed using recent and historical case reports to highlight key
points.
Today, the names Bach and Mozart are mostly associated with Johann
Sebastian Bach and Wolfgang Amadeus Mozart. But this volume of Bach
Perspectives offers essays on the lesser-known musical figures who
share those illustrious names alongside new research on the
legendary composers themselves. Topics include the keyboard
transcriptions of J. S. Bach and Johann Gottfried Walther; J. S.
Bach and W. A. Mozart's freelance work; the sonatas of C. P. E.
Bach and Leopold Mozart; the early musical training given J. C.
Bach by his father and half-brother; the surprising musical
similarities between J. C. Bach and W. A. Mozart; and the latest
documentary research on Mozart's 1789 visit to the Thomasschule in
Leipzig. An official publication of the American Bach Society, Bach
Perspectives, Volume 14 draws on a variety of approaches and a
broad range of subject matter in presenting a new wave of
innovative classical musical scholarship. Contributors: Eleanor
Selfridge-Field, Yoel Greenberg, Noelle M. Heber, Michael Maul,
Stephen Roe, and David Schulenberg
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