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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.
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.
Management of Heart Failure: Surgical will provide the full spectrum of surgical options, ICU management and rehabilitation, while also referencing heavily the companion volume of Management of Heart Failure: Medical by introducing the medical options in heart failure . The contributing authors are all key opinion leaders in the medical management of heart failure. This volume is designed to integrate with its sister medical title, but also alone be the definitive guide to the surgical management of heart failure.
Left ventricular assist devices (LVADs) have been shown to be superior to medications (beta blockers, digoxin, ace inhibitors, diuretics) for management of advanced heart failure. Other surgical alternatives, like mitral valve repair, aortic valve repair, and the Dor procedures (remodeling the shape of the left ventricle) are also important in the management of patients with CHF. These are topics that will all be covered in the book.
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.
Treatment of Advanced Heart Disease is an expansive and up-to-date guide to the diagnosis and treatment of heart failure in children and adults. Written by leading specialists, this source guides the clinician through the possible causes of heart disease and emphasizes potentially reversible etiologies, in addition to reviewing currently available therapies including drugs, devices, surgery, and research sure to impact the field for years to come. Leads the reader through crucial treatment practices and strategies to sustain the lives of patients with severe heart disease.
This engaging book provides a state-of-the-art introduction to the rapidly evolving field of mechanical circulatory support therapy in the care of patients with advanced heart failure. It is aimed at healthcare teams around the world who are involved in patient care, research, and teaching of advanced heart failure; healthcare professionals in training; and interested lay persons.In particular, this book• serves as a comprehensive resource and practice guide on all aspects of mechanical circulatory support therapy, starting with an overview on heart failure management and then continuing with the referral and evaluation, the care before and after mechanical circulatory support implantation, the analysis of outcomes and complications, as well as a description of research and societal perspectives in the field of mechanical circulatory support therapy;• is founded on the expertise of Columbia University Medical Center (New York City), which has one of the most renowned heart failure, mechanical circulatory support, and heart transplantation programs in the world;• takes a multidisciplinary integrated healthcare team approach, including the perspectives of cardiologists, cardiac surgeons, nurses, coordinators, social workers, psychologists, physical therapists, financial experts, and bioethicists; and• provides in a unique way the complementary viewpoints from the expert healthcare team's as well as the patient's and family's perspectives, with patient vignettes interspersed throughout the entire text./a
This text provides the surgeon and cardiologist with a unique review of the surgical options available for the treatment of patients with severe left ventricular dysfunction, including their indications and results. The full spectrum of surgical therapies is covered, from the more conventional techniques of coronary artery bypass, valve replacement, left ventricular aneurysm resection and transplantation to the new technique of ventriculectomy. The future of permanent mechanical hearts and xenotransplantation is also discussed. The authors include an international panel of experts with recognized expertise in their fields.
This book provides the most up to date information on every aspect of clinical care relating to patients with advanced heart failure who require mechanical circulatory support as a treatment strategy. The book begins with an extensive description of the preoperative patient selection process as well as preoperative medical optimization, including bridge to bridge strategies with short-term devices. The book then transitions into a description of a variety of surgical implantation techniques with special considerations for reoperative surgery. A chapter on intraoperative anesthesia management is specifically focused on intraoperative issues relating to MCS patients. Subsequent chapters focus on perioperative management as well as long-term management of patients on MCS, including optimization of a patient’s LVAD speed. A dedicated chapter on the diagnosis of device thrombosis as well as surgical techniques and outcomes associated with device exchanges is also included. The book also summarizes the national and international outcomes data for using MCS as a bridge to transplant and destination therapy. There is also a chapter on the utility of stem cells as an adjunct technique for inducing myocardial recovery. Finally, the book has chapters on complications of MCS, management of right ventricular failure, and the future of MCS.
Despite all efforts and success in medical treatment, the incidence of (end-stage) chronic heart failure is increasing. Cardiac transplantation remains the only definite option; however, due to the shortage of donor organs, very few people benefit. Therefore, surgery of end-stage heart failure using conventional techniques has gained new interest after the introduction of the Batista operation. However, a clear surgical identification of the patients to be included in this group is lacking. Left ventricular reduction surgery as well as reduction of the base of the heart using mitral annuloplasty or mitral valve replacement, sparing both papillary muscles, is used in selected patients with satisfying results and good survival. Long-term mechanical support with subsequent surgical remodeling or supporting myoplasty may result in a beneficial alternative to heart transplantation.