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James C. Fang, MD, and Gregory S. Couper, MD, have assembled a panel of prominent surgeons and cardiologists to review the latest clinical, scientific, and investigational surgical and mechanical approaches to heart failure in hopes of improving the lives of this challenging group of patients. Topics range from such traditional strategies as high-risk surgical revascularization in advanced coronary artery disease, to more novel approaches such as ventricular reconstruction and mechanical assist devices. Many chapters are contributed by the original pioneers of specific surgical techniques, which provide s invaluable perspective from personal experience.
Surgical Management of Heart Failure brings together the current knowledge on the surgical management of heart failure into one volume. It is designed to have copious illustrations and photographic material that will explain the techniques and surgical management of patients with heart failure in an effective modern format.
Congestive heart failure (CHF) is one of the most common killers worldwide and is becoming more prevalent as the population continues to age. Despite great advances in medical drug treatment and the liberal use of pacemakers and internal defibrillators, the outcome of CHF remains poor, which has prompted investigators to consider new surgical options for its management. This special issue compiles contributions from a select group of investigators and experts from premier medical centers. It covers many important topics, including aortic valve replacement for valvular cardiomyopathy, mitral valve repair, myocardial revascularization in patients with ventricular dysfunction, the pros and cons of beating heart versus on-pump coronary artery bypass surgery (CABG), and clinical trials comparing CABG to percutaneous coronary interventions. The ongoing clinical trials in the surgical management of CHF, the experience with ventricular reduction and remodeling surgery as well as the current status of heart transplantation are reviewed. Consideration is also given to resynchronization therapy and biventricular pacing for CHF, and the use of ventricular assist devices as destination therapy and as a bridge to transplantation or recovery. The reader is updated on the clinical experience with the Jarvik 2000 ventricular assist device and the AbioCor total artificial heart. Further novel approaches discussed are gene therapy for premature coronary artery disease, therapeutic angiogenesis, transmyocardial laser revascularization and cardiac xenotransplantation. This publication will be of special interest to clinicians and investigators in cardiology and cardiac surgery, medical and surgical residents and fellows in training, and general practitioners.
For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
The treatment of end-stage heart failure with advanced surgical therapies has evolved significantly over the last several years and is a dynamic subspecialty within cardiac surgery. Surgical Treatment for Advanced Heart Failure describes the surgical management of advanced heart failure, including coronary artery revascularization, mitral valve repair, aortic valve replacement, ventricular remodeling, cardiac resynchronization, mechanical circulatory support with short-term devices for acute stabilization, long-term mechanical support as a bridge to transplant and for destination therapy, left ventricular assist devices, complete cardiac replacement with the total artificial heart, and cardiac transplantation. With contributions from a distinguished group of heart failure cardiologists and transplant surgeons, it is an authoritative resource for cardiac surgeons, cardiologists, and surgeons.
The treatment of end-stage heart failure with advanced surgical therapies has evolved significantly over the last several years and is a dynamic subspecialty within cardiac surgery. Surgical Treatment for Advanced Heart Failure describes the surgical management of advanced heart failure, including coronary artery revascularization, mitral valve repair, aortic valve replacement, ventricular remodeling, cardiac resynchronization, mechanical circulatory support with short-term devices for acute stabilization, long-term mechanical support as a bridge to transplant and for destination therapy, left ventricular assist devices, complete cardiac replacement with the total artificial heart, and cardiac transplantation. With contributions from a distinguished group of heart failure cardiologists and transplant surgeons, it is an authoritative resource for cardiac surgeons, cardiologists, and surgeons.
Despite the significant decline in heart disease mortaht>' rates over the last 25 years, heart failure has remained a significant problem. We are now confronted with large numbers of terminally ill patients for whom conventional therapies for heart failure have been exhausted and for whom repeated hospital visits are necessary. There now is a major thrust towards a management strategy which embraces a comprehensive approach including vigorous preventive measures and earlier surgical interventions. This book outlines the major surgical options for the treatment of heart failure and brings together a very broad base of opinions with contributions from several outstanding individuals. With the improved knowledge and techniques to control rejection, transplantation has become the central pillar in the surgical management of this group of patients. Unfortunately, because of limited donor supply the teclmique cannot be applied to large numbers of patients. A great deal of excitement, however, exists in the potential for xenotransplantation as a supplement to homotransplantation. The use of cardiac assist devices has become a reality with several hundred LVADS and BiVADS implanted throughout the world and cardiac replacement with total artificial hearts continues to be used successfully as a bridge to transplantation. We are on the thieshold of the broad application of assist devices to provide prolonged relief of heart failure and restore patients to an ambulatoiy home environment and hopefully return to the work force in significant numbers.
Approximately 120 different surgical procedures are used to correct congenital heart diseases, and the burden that this places on the surgeon is compounded by the exceptional complexity of the techniques and the rarity of many of the lesions. Training is problematic, not least because of legal issues, and currently available texts, drawings and images are no substitute for real ‘live’ surgery. Against this background, the authors have set out to create an interactive multimedia manual that covers many aspects of congenital heart surgery. Each heart defect is addressed in an individual chapter, elaborating specific surgical anatomy and indication for surgery of heart defect first, followed by video clips depicting the operative approach and technique. The clips are accompanied by a clear descriptive narrative and patient history and diagnostic images are available to provide a clear backdrop to the operation. The chosen format makes this manual not only a very powerful teaching tool for practicing cardiac surgeons and surgeons in training but also a valuable source of information for related services such as pediatric and adult cardiologists, cardiac anesthesiologist, cardiac intensivists, perfusionists and medical students.
The ability to read a paper, judge its quality, the importance of its results, and make a decision about whether to change practice based on the information given, is a core skill for all doctors. To be able to do this quickly and efficiently is, without a doubt, a skill needed by all time-pressured emergency doctors and one which is tested in the Fellowship of the College of Emergency Medicine (FCEM) examination. Critical Appraisal for FCEM is the essential revision source for all those who want to pass the critical appraisal section of this exam. It is also required reading for those who want to incorporate evidence-based medicine into their everyday clinical practice. Features: Helps you become truly competent in critical appraisal Provides information in "Spod’s Corner," which helps you reach the next level and excel Prepares you for the Critical Topic Review Contains two fictional practice papers to test and practise your knowledge With its relaxed conversational style—yet crammed with essential information, key tips, and advice—this book is indispensable for all those wanting to achieve success in their FCEM and MCEM examinations.
Providing optimal care for heart failure patients is a complex challenge that requires cooperation and coordination across multiple disciplines. Now, you can apply the successful techniques pioneered at the Cleveland Clinic, which are carefully explored and explained in this text. Drs. McCarthy and Young draw on their experience to show how an interdisciplinary team works together to: arrive at a proper diagnosis initiate medical therapy make decisions regarding the best use of percutaneous therapies, surgical therapies, electrical therapies, and the use of mechanical circulatory support devices and transplantation. Throughout the book, they present the most updated evidence for both drug trials and surgical trials. They emphasize the benefits of performing the most complete surgery that is practical, then continuing medical therapy. Each chapter focuses on one aspect of treatment, but the authors recognize that the best way to manage an individual patient is often to adapt a variety of different therapies. They state their opinions clearly, identifying which part of care is science and which is art. Heart Failure: A Combined Medical and Surgical Approach is a true collaboration that helps you identify the most effective strategies – operative interventions, pacing and ICD treatment, new diagnostic tools, and pharmacotherapeutic developments – and implement them for your patients.