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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.
This timely book reveals an integrated approach to myocardial preservation focusing on translational research and clinical applications. Chapters cover both the mechanisms of heart failure in addition to therapeutic considerations, including forms of cardiac cell death, cardiac remodelling and cardiac regeneration. Potential future research directions are also proposed, enabling the reader to gain a broad in-depth understanding of the topic. Myocardial Preservation: Translational Research and Clinical Application presents a thorough review of myocardial preservation. Its comprehensive approach provides a valuable reference for cardiology researchers and practising and trainee cardiologists seeking new insight to the topic.
This volume in the acclaimed Mastery Series delivers clear, how-to guidance on the most commonly performed procedures in adult and pediatric thoracic surgery. As with other volumes in the series, Mastery of Cardiothoracic Surgery delivers expert commentary from master surgeons following each chapter. Invaluable for cardiothoracic fellows, as well as thoracic and cardiac surgeons.
Myocardial ischemia and subsequent reperfusion of the ischemic myocardium represent complex phenomena encompassing numerous physiological processes. This book aims at enhancing our understanding of these processes and stresses recent important developments in this very active area of research. The concise, state-of-the-art reviews cover recent advances in many fields important to the area of myocardial ischemia and reperfusion including physiology, pathology, pharmacology, biochemistry and molecular biology with reference to clinical relevance and applicability of these findings. Major areas which are highlighted include vascular mechanisms resulting in myocardial ischemia, cellular events in the ischemic, postinfarcted and reperfused myocardium as well as new exciting developments in cardiac protection that involve both novel pharmacological approaches as well as endogenous cardioprotective mechanisms such as preconditioning. Aimed at both the basic and clinical cardiovascular investigator, the book comprehensively reviews the rapid progress made in recent years in understanding the etiology of myocardial ischemia and reperfusion. It will further serve as an authoritative reference for all those interested in learning about the important developments in the treatment of myocardial ischemic and reperfusion disorders.
This book is a comprehensive overview of heart failure and cardiac transplantation and integrates scientific and clinical information about the physiology, pathophysiology, diagnosis, and treatment of this disorder. Organized into five parts, it reviews the history and basic mechanisms of heart failure; etiology of heart failure; heart failure disease progression; advanced therapies for heart failure; and cardiac transplantation. The book presents basic concepts in the physiology, molecular biology, pathology, and epidemiology of the normal and failing heart; known causes of heart failure, such as right heart failure, valvular cardiomyopathy, molecular mechanisms of sarcomeric cardiomyopathies, and neuromuscular cardiomyopathy; cardiorenal syndrome; neurohormonal activation; cardiac resynchronization, ventricular assist devices; regenerative mechanisms; orthotopic heart transplantation; early and late management of the post-transplant patient; heart transplantation and antibody-mediated rejections; heart-lung transplantation; and cardiac xenotransplantation. Featuring contributions from leaders in the fields of heart failure, cardiac transplantation, cardiac pathology, and cardiovascular molecular research, Congestive Heart Failure and Cardiac Transplantation is a valuable compendium for cardiologists, cardiothoracic surgeons, researchers, trainees, and students.
The topic of heart failure although extensively researched and reported, has several gray areas. This is especially seen in determining strategies for combating advanced heart failure. The global burden of ischemic heart disease is increasing at an alarming rate to almost pandemic proportions. Even in the presence of state-of the art technology for prompt and successful coronary reperfusion, the population progressing to ischemic cardiomyopathy is substantial. The treatment strategies for ischemic cardiomyopathy do not always ensure optimal clinical results, the reasons for which are varied. The proper patient selection is vital as is the tailoring of suitable therapy. The approach is thus multi-pronged, of which surgical ventricular restoration (SVR) has a definite role. Despite various randomized studies like the STICH-hypothesis 2, where there was a huge selection bias, with patients subjected to an erroneous technique of SVR, with inadequate ventricular remodelling assessment. The present need is to understand the unique anatomy of the left ventricle, its function and perturbations with the onset of heart failure, in order to plan therapeutic strategies to restore near normal anatomy and function. A study of the hemodynamics in ischemic cardiomyopathy is essential, as it differs in certain aspects from other causes of heart failure like idiopathic dilated cardiomyopathy and valvular heart diseases. Since information on these aspects are scattered in various scholarly articles, a concise source in the form of a book would be appropriate and useful for both cardiologists and cardiac surgeons. This project represents a concise review of normal and abnormal cardiac anatomy and physiology, the evolution of SVR to EVLPP with validation of near normal ventricular restoration, plus act as a reference guide for cardiac surgeons with interest in SVR.
The importance of the developmental approach for experimental and clinical cardiology is indisputable. Clinical-epidemiological studies have clearly shown that the risk factors of serious cardiovascular diseases, such as atherosclerosis and ischemic heart disease, are already present during the early phases of ontogenetic development. Furthermore, congenital cardiovascular malformations remain the single largest cause of infant mortality from congenital defects in industrial countries. It is therefore not surprising that the interest of theoretical and clinical cardiologists in the developmental approach keeps increasing. Advances in molecular biology accelerated this trend substantially. This book is based on contributions presented at the international symposium The Developing Heart in Prague in May 2000. It is our contention that the biological, electrophysiological, morphological, functional, biochemical and functional approaches employed by distinguished scientists worldwide will provide the reader with a global picture for changes characterizing the developing heart. It should stimulate the curiosity of cardiovascular scientists in gaining insight into the mechanisms of normal and pathological development.
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.
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.
Myocardial protection is regarded as one of the most important, yet also most controversial aspects of cardiac surgery. There has been considerable improvement in myocardial protection strategies over recent years, utilising a variety of new approaches to treat cardiac diseases, and this text is intended to embrace the state of the art in this field. The book summarises the state of knowledge on all aspects of myocardial protection, including the latest in the treatment of cardiac diseases, robotics, pediatric surgery and the treatment of cardiac failure. Robotic surgery, valvular surgery, pediatric surgery and coronary surgery are all covered by renowned experts, producing a comprehensive, forward-looking view of the field of myocardial protection. This book should function to update physicians and surgeons interested in the field of cardiac surgery on the current state of knowledge on myocardial protection.