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Introductory Chapter: Introduction to Advanced Concepts in Endocarditis.
A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.
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.
Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy.
Introductory Chapter: Dedicated Initial Giants Breaking the Barriers to Successful Cardiac Transplantation Therapy.
Heart failure is defined as reduced ability of the heart to pump blood and maintain normal bodily function. Heart transplantation is currently the preferred treatment for end-stage heart failure but the supply of donor hearts is insufficient to meet the need and many patients are not eligible for transplantation due to age or comorbid conditions. Implantable mechanical pumps can assist the circulation of blood by the ventricles. Left ventricular assist devices (LVADs) have been approved by the U.S. Food and Drug Administration (FDA) for use in patients awaiting transplant (a bridge to transplant) and as a last resort in patients with refractory heart failure who are not eligible for a heart transplant (destination therapy). In January 2010, the first newer generation, rotary continuous flow ventricular assist device (HeartMate II) was approved by the FDA for destination therapy. Eligibility criteria are essentially the same as those used to select patients for the pivotal clinical trial that included patients with shortness of breath and/or fatigue at rest or during minimal exertion despite treatment with optimal therapy for heart failure associated with a low ejection fraction (
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Ideal for cardiologists who need to keep abreast of rapidly changing scientific foundations, clinical research results, and evidence-based medicine, Braunwald’s Heart Disease is your indispensable source for definitive, state-of-the-art answers on every aspect of contemporary cardiology, helping you apply the most recent knowledge in personalized medicine, imaging techniques, pharmacology, interventional cardiology, electrophysiology, and much more! Practice with confidence and overcome your toughest challenges with advice from the top minds in cardiology today, who synthesize the entire state of current knowledge and summarize all of the most recent ACC/AHA practice guidelines. Locate the answers you need fast thanks to a user-friendly, full-color design with more than 1,200 color illustrations. Learn from leading international experts, including 53 new authors. Explore brand-new chapters, such as Principles of Cardiovascular Genetics and Biomarkers, Proteomics, Metabolomics, and Personalized Medicine. Access new and updated guidelines covering Diseases of the Aorta, Peripheral Artery Diseases, Diabetes and the Cardiovascular System, Heart Failure, and Valvular Heart Disease. Stay abreast of the latest diagnostic and imaging techniques and modalities, such as three-dimensional echocardiography, speckle tracking, tissue Doppler, computed tomography, and cardiac magnetic resonance imaging. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
An all-in-one guide to mechanical assist devices for the treatment of heart failure This complete guide addresses all of the clinical scenarios encountered by the health care team during the pre-operative, intra-operative, and post-operative periods following device implantation. In addition, it outlines the specific attributes of various technologies that are currently utilized by clinicians, giving you a practical view of how the latest devices work. You’ll also find a mini-catalog of the spectrum of current devices, complete with their technical and clinical specifications. Drawing on the latest published data and the combined global expertise of a renowned author team, Mechanical Circulatory Support puts the field’s most essential perspectives right at your fingertips. FEATURES: The unmatched mechanical circulatory device sourcebook, covering the physiological, technical, regulatory, and clinical aspects of ventricular assist devices Full-color presentation features a wide range of photographs, radiographs, tables, and clearly labeled clinical and schematic illustrations Essential insights into the physiology of heart failure, which provides a basic foundation of knowledge for understanding the role of mechanical circulatory assistance in the management of heart failure Logical two-part organization consisting of: Clinical Considerations in mechanical circulatory support, including device history/development and indications for device therapy; perioperative management; complications; and special considerations (use in infants/children, pulmonary hypertension during LVAD support, and more) Device-Specific Considerations, which provides a mini-catalog of manufacturer’s devices—-from short-term devices to long-term continuous flow devices—-and highlights technical and clinical specifications for each product Guide to appropriate device selection using a simplified framework in an industry that produces an increasing array of short- and long-term therapies Helpful chapter introductions provide essential background information that places each chapter topic in its proper clinical and technical context Conclusions at the end of each chapter offer a concise summary of chapter material Full chapter-ending references provide opportunities for further research
Mechanical Circulatory and Respiratory Support, Second Edition, continues to provide a comprehensive overview of the past, present and future development of mechanical circulatory and respiratory support devices. This new edition provides an update on the field while also introducing new elements within the field such as ex-vivo perfusion, devices for HFpEF, design for manufacture, oxygenator design, and more content on route to market. Chapters from over 60 internationally-renowned experts focuses on the entire life-cycle of mechanical circulatory and respiratory support – from the descent into heart and lung failure, alternative medical management, device options, device design, implantation techniques, complications and medical management of the supported patient, patient-device interactions, cost effectiveness, route to market and a view to the future. This second edition is a useful resource for biomedical engineers and clinicians who are designing new mechanical circulatory or respiratory support devices, while also providing a comprehensive guide of the entire field for those who are already familiar with some areas and want to learn more. Reviews of the most cutting-edge research are provided throughout each chapter, along with guides on how to design new devices and which areas require specific focus for future research and development. - Presents an engineering pathway to develop the most advanced medical devices - Features a clinical summary of how to select the right patients and treat them optimally while supported with these devices - Includes a detailed path to market for those developing new devices in this field