Cardiac surgery has developed dramatically since the first open-he art operations were performed in the mid 1950s. Although the improvement of surgical technique, extracorporeal circulation, and postoperative management has contributed to a marked reduction of morbidity and mortality, the development of cardiac surgery to its present state would not have been possible without blood substitution by homologous donor blood. Only 20 years ago, open-heart operations required an average of 8 units of blood preserves. The excessive need of donor blood in those early days was mainly due to premature surgical technique, insecure control of anticoagulation, severe blood trauma by extracorporeal circulation, and the lack of retransfusion technologies that would have allowed the reuse of shed mediastinal blood. The introduction of new technologies, such as normovolemic hemodilution, in traoperative autotransfusion, postoperative return of shed mediastinal blood, and predonation of autologous blood has greatly reduced donor blood requirements. At present the majority of routine coronary artery surgical procedures can be performed without any blood transfusion. Blood loss, however, may be considerable in patients undergoing complex valve surgery or reoperations, as they often require several units of transfused blood. Blood conservation has now become an area of major interest for the cardiac surgeon. This increased concern is caused by infectious complications of blood transfusion, in particular hepatitis and, more recently, AIDS.
Advanced Therapy in Cardiac Surgery - Second Edition This second edition of Advanced Therapy in Cardiac Surgery presents state-of-the-art techniques and an in-depth review of cardiac surgery from the leading authorities. Each of the 62 succinct chapters represents the personal treatment protocols of the experts. The Advanced ......
Here, two of the foremost cardiothoracic surgeons have brought together many of the top cardiologists and haematologists to produce the most current reference source on all aspects of blood conservation, from an overall clinical approach to the use of erythropoietin and the benefits of post-operative blood salvage. The subject matter covers numerous areas involved in the preoperative considerations in cardiac surgery, the intraoperative decision-making in cardiac surgery, postoperative bleeding and management and a section on the algorithm for bloodless surgery used at the New York Hospital-Cornell Medical Center.
This book provides a multidisciplinary approach to the maintenance of hemostasis and minimisation of blood loss in patients undergoing cardiac surgery. All aspects of patient blood management are covered that may contribute to a reduction in perioperative bleeding and transfusion requirements in cardiac surgery. This is achieved through practical cases and a theoretical background that gives a better understanding of patient hemostasis and the occurrence of bleeding complications. This book is relevant to cardiac surgeons, anesthesiologists, clinical perfusionists, hematologists and intensivists.
difficult, to represent it as the surgeon sees it, and to understand the anat omy, which is not always visible. In part, this was accomplished by paint ing on both surfaces of transparent paper to create the illusion of looking through superficial layers to the deeper structures. A combination of color media, including colored pencil, graphite, carbon, pastels, and transparent and opaque watercolors, enabled me to convey the field with minimal loss of reality or dimension. Of equal importance was the availability, for every illustration, of direct surgical observation, surgical photographs, fresh specimens, and the surgical instruments. The sequence of creation was first the discus sion of desired illustrations, then a rough sketch, consultation with the surgeons, finished pencil drawing, another consultation, and finally the color rendering. These color renderings were then checked against actual surgery for accuracy in representation of tissues, instrumentation, tissue responses to manipulation, and consistency of representation. From these processes evolved a technique that facilitated the flow of information, in logical sequence, from one step to the next and from one procedure to another, always focusing the attention of the audience toward what is pertinent and away from the extraneous.
The topics in this book represent the presentations given at the Fifth Annual Meeting entitled "Cardiac Surgery: Current Issues" held at the Frenchman's Reef Beach Resort, St. Thomas, U.S. Virgin Islands, November 18-20, 1993. This symposium was sponsored by the Division of Cardiothoracic Surgery, the School of Cardiovascular Perfusion and the Department of Nursing Education and Quality Assurance of Cooper Hospital/University Medical Center, the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey, as well as the Academy of Medicine of New Jersey. Chapter authors were charged with the task of writing brief overviews of major issues related to the field of cardiac surgery. The book is specifically tailored to the needs of cardiothoracic surgeons, cardiovascular perfusion ists, allied health professionals and nursing personnel involved in all phases of caring for the cardiac surgical patient. Although intended as a reference source with emphasis on up-dated approaches applied in cardiac surgery, it is hoped that the discussion of these topiCS will compliment other texts and manuscripts. Obviously, a book of this length cannot cover the whole multidisciplinary and complex field of cardiac surgery. However, co-editors are certain that the annual appearance of this text will highlight comprehensive, new and Interesting approaches to the field of cardiac surgery.
Principles and Techniques of Extracorporeal Circulation
Author: Christina T. Mora
Publisher: Springer Science & Business Media
A definitive, comprehensive text on the technological developments and clinical applications of this critical subject matter. Written for the entire heart surgery team, this volume covers the physiology of cardiopulmonary bypass, mechanics and components of the heart-lung machine, the conduct of cardiopulmonary bypass in cardiac surgery, non-cardiac applications of cardiopulmonary bypass, and mechanical assistance of the failing heart and lung. The authors also give special consideration to such areas as blood conservation in cardiac surgery, religions objections to blood transfusions, medical-legal aspects and cardiopulmonary bypass, as well as warm blood cardioplegia and normothermic cardiopulmonary bypass.
This policy and procedure book is a valuable resource for new or existing cardiac surgery programs. It provides support for each procedure in the cardiac surgery environment to include standards of practice, risk management, staffing competencies, and quality indicators to optimize care of the cardiovascular surgery patient. The policy manual is based upon AORN standards and meets JCAHO standards for the operating room environment.
Cardiac surgical procedures are among the most common and most complicated forms of surgery worldwide and the postoperative period is characterized by complex challenges. Among the factors determining ultimate clinical outcome, postoperative critical care is of major importance. This book adopts a clinical approach in explaining and analyzing the course of clinical care in patients undergoing cardiac surgery. Since the postoperative clinical status is directly influenced by preoperative and intraoperative factors, the early chapters briefly examine preoperative issues and the intraoperative course of cardiac surgery, with particular attention to anesthesia and the process of cardiopulmonary bypass. Subsequent chapters primarily address the critical care of patients by means of an organ-oriented approach, which will enable the reader to use the text as a "cookbook" of cardiac intensive care. This book is intended for use in daily practice by cardiac surgeons, cardiac anesthesiologists, intensivists and cardiac intensive care nurses.
A comprehensive review by renowned authorities of the many exciting developments occurring across the rapidly emerging field of "minimally invasive" or "minimal access" cardiac surgery. The book's distinguished panel of contributors presents the interventional cardiologists perspective, spells out the key factors for success in beating-heart coronary bypass grafting through limited incisions, and surveys the various methods of harvesting the internal thoracic artery. Other topics treated include immobilization of the surgical field, minimal access valve and congenital surgery, alternative methods of anastomosis, and port-access coronary bypass grafting. Minimally Invasive Cardiac Surgery summarizes all the latest findings on the powerful new techniques, as well as the results, of minimally invasive coronary surgery, including valvular heart disease, congenital heart disease, and coronary revascularization.
Optimize perioperative outcomes with Kaplan’s Cardiac Anesthesia! Dr. Joel L. Kaplan and a host of other authorities help you make the best use of the latest techniques and navigate your toughest clinical challenges. Whether you are administering anesthesia to cardiac surgery patients or to cardiac patients undergoing non-cardiac surgery, you’ll have the guidance you need to avoid complications and ensure maximum patient safety. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices. Update your understanding of cardiovascular and coronary physiology, and the latest advances in molecular biology and inflammatory response mechanisms. Master the newest approaches to perioperative assessment and management, including state-of-the art diagnostic techniques. Tap into the latest knowledge about 2D and 3D transesophageal echocardiography, anesthesia delivery for minimally invasive/robotic cardiac surgery, assist devices and artificial hearts, cardiac pacing, cardiac resynchronization therapy, ablation techniques, and more. Access the complete contents online at Expert Consult, plus additional online-only features including an ECG atlas...videos that demonstrate 2-D and 3-D TEE techniques in real time...and an Annual Year End Highlight from the Journal of Cardiovascular Anesthesia that’s posted each February. Clearly visualize techniques with over 800 full-color illustrations.
Publisher: Karger Medical and Scientific Publishers
Diseased heart valves are a growing public health concern, ranging among the most important causes of heart failure and sudden death. This volume reviews the most current information on valvular disease pathophysiology, epidemiology and evaluation as well as management strategies for affected patients. Topics discussed include data supporting selection of asymptomatic patients for valve surgery, methods employed in evaluating patients for this purpose, surgical methods and valve prostheses currently applied for valve repair and replacement, and criteria for selecting among them. Adjunctive problems such as aortic root disease, infective endocarditis and arrhythmias that may modify patient management are also considered. Epidemiologic data illustrate the increasing prevalence of valvular disease in the population. In addition, the book reviews new and emerging knowledge about the molecular and cellular basis of myocardial dysfunction and heart failure in various forms of valvular disease, and new information about the potential roles of alternative medicine, blood conservation and minimally invasive surgical techniques. A particular highlight is a 'debate' between paired chapters on the appropriateness of mitral valve surgery for patients with less than severe mitral regurgitation of ischemic etiology. Compiling the most up-to-date and authoritative information in the field, this book will be of great value not only to cardiologists and cardiac surgeons, but also to medical students, medical and surgical residents, cardiology and cardiac surgery fellows and general internists.
As appropriately outlined in the first chapter in cells was pioneered in Holland by Van Loghem and part II in this book, the history of contemporary Van Rood, and it led eventually to the discovery of blood transfusion is only three-quarters of a cen the HLA system and its subsequent explosive de tury old. On the surface, there is not much left in velopment. In biochemistry, the work on the ABO common between an arm to arm blood transfer and MN blood group substances has provided carried out as an heroic measure in the twenties, pointers to general features of the biosynthesis and when patient or donor had to be weighed in order role of glycolipids and glycoproteins in the cell for the physician to decide when to stop, and blood membrane, and the identification of serological component therapy of today, when several patients specificities associated with specific oligo sac can benefit from appropriately measured and stan chari des has proven for the first time how gene dardized amounts of various purified blood frac products that are not proteins can exhibit Men tions. Yet, the basic principles of blood transfusion delian inheritance.
Make informed clinical decisions with reliable, up-to-date guidance from Evidence-Based Practice of Anesthesia, 3rd Edition! Leading authority Lee A. Fleisher, MD expertly explores the full range of important issues in perioperative management, discussing the available options, examining the relevant research, and presenting practical recommendations. Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located. Make sound, evidence-based decisions on every aspect of patient care: preoperative assessment, monitoring and administration of anesthesia during surgery, postoperative intensive care management, and postoperative pain management. Master the current best practices you need to know for day-to-day practice and oral board review. Confidently navigate the latest issues thanks to new chapters on optimal airway management in GI endoscopy, the role of Ketamine for perioperative management, fast-track surgery, and hypothermia after intraoperative cardiac arrest, plus many other vital updates. Efficiently translate evidence into practice with numerous quick-reference tables and short, well-organized chapters that promote fast and effective decision making. Get practical decision-making tools you can use in both routine care and complicated or special situations.
Winner of a HIGHLY COMMENDED AWARD in the Surgical specialties category of the 2011 BMA Medical Book Competition. Key Questions in Cardiac Surgery will systematically cover all the main topics involved in the current practice of a cardiac surgeon. It will incorporate current guidelines for practice (such as from the American Heart Association and European Society of Cardiology) and up-to-date information based on current literature. The data and body of knowledge presented in this book are strictly evidence-based which makes it ideal as a revision aid for residents/registrars undertaking their Cardiothoracic Surgery Board examinations around the world. Although these examinations vary in format in different countries, this book is applicable to all cardiothoracic surgical trainees. Its concise, yet complete coverage of the important topics, make it the ideal guide to answer the key questions in cardiac surgery that are asked within the confines of an examination. Cardiologists, cardiothoracic intensive care unit specialists, nursing staff, physiotherapists and other professions allied to medicine, both surgical and cardiological, will also find the book useful in terms of the indications and surgical management of these patients, as they are integral to the cardiac surgical process.
The purpose of this clinical transfusion medicine handbook is to take the reader through a variety of clinical problems, each one likely to be encountered in a busy teaching hospital. The reader follows the stream of clinical and laboratory data, developing the ability for critical thinking which leads him/her to diagnosis and appropriate management. The book is a lively illustration of various clinical problems in transfusion medicine, including immune complications, microbiological problems, blood component use, apheresis techniques, and management of complex situations such as multiple trauma, sickle cell crisis, and organ transplantation. Each case is carefully chosen and presented, with incorporated questions, leading the reader towards solution of the problem in a logical and didactic manner
Through seven successful editions, Sabiston & Spencer Surgery of the Chest has set the standard in cardiothoracic surgery references. Now, the new 8th Edition, edited by Frank W. Sellke, MD, Pedro J. del Nido, MD, and Scott J. Swanson, MD, carries on this tradition with updated coverage of today's essential clinical knowledge from leaders worldwide. Guidance divided into three major sections—Adult Cardiac Surgery, Congenital Heart Surgery, and Thoracic Surgery—lets you quickly find what you need, while new and revised chapters reflect all of the important changes within this rapidly evolving specialty. Expert Consult functionality—new to this edition—enables you to access the complete contents of the 2-volume set from anyplace with an Internet connection for convenient consultation where and when you need it. This is an ideal source for mastering all of the most important current knowledge and techniques in cardiac and thoracic surgery—whether for specialty board review or day-to-day practice. Features short, focused chapters that help you find exactly what you need. Presents the work of international contributors who offer a global view of the entire specialty. Covers thoracic surgery as well as adult and pediatric cardiac surgery for a practical and powerful single source. Includes nearly 1,100 illustrations that help to clarify key concepts. Features online access to the complete contents of the 2-volume text at expertconsult.com for convenient anytime, anywhere reference. Covers the hottest topics shaping today's practice, including the latest theory and surgical techniques for mitral valve disease, advances in the treatment of congenital heart disease, minimally invasive surgical approaches to the treatment of adult and congenital cardiac disease and thoracic disease, stent grafting for aortic disease, and cell-based therapies. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.