Direct Myocardial Revascularization: History, Methodology, Technology PDF Download

Author: Peter Whittaker
Publisher: Springer
ISBN: 9781461550709
Category : Medical
Languages : en
Pages : 202

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Book Description
The last five years have witnessed an increasing interest in the subject of transmyocardial laser revascularization (TMR) as illustrated by the number of abstracts presented at the meetings of the American Heart Association and the American College of Cardiology (Figure). The ideas and concepts associated with this particular method of myocardial revascularization have changed dramatically over even this short period of time. The original premise of "de-evolving" mammalian hearts to recreate a reptilian-like myocardial circulation by making multiple channels through the myocardium has been almost (but perhaps not quite) completely dismissed. Now, the most popular notion is that there is an angiogenic response to myocardial channel making. It is this development of new blood vessels that is thought to be responsible for the apparent improvements in symptoms and blood flow. Along the way, the idea that a channel could stay open and allow blood to flow directly from the ventricular chamber has found little support. Rather than directly explore all of these issues and merely duplicate previously published articles, our aim was to take a novel approach: that is, to step back from these arguments and provide perspective from the vantage point of distance. In the case of trans myocardial revascularization, distance comes both in terms of history and in terms of methodology and knowledge from other fields of research. Historically, innovative methods of myocardial revascularization are by no means uncommon. The first two chapters deal with this historical' perspective.

Author: Peter Whittaker
Publisher: Springer Science & Business Media
ISBN: 1461550696
Category : Medical
Languages : en
Pages : 202

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Book Description
The last five years have witnessed an increasing interest in the subject of transmyocardial laser revascularization (TMR) as illustrated by the number of abstracts presented at the meetings of the American Heart Association and the American College of Cardiology (Figure). The ideas and concepts associated with this particular method of myocardial revascularization have changed dramatically over even this short period of time. The original premise of "de-evolving" mammalian hearts to recreate a reptilian-like myocardial circulation by making multiple channels through the myocardium has been almost (but perhaps not quite) completely dismissed. Now, the most popular notion is that there is an angiogenic response to myocardial channel making. It is this development of new blood vessels that is thought to be responsible for the apparent improvements in symptoms and blood flow. Along the way, the idea that a channel could stay open and allow blood to flow directly from the ventricular chamber has found little support. Rather than directly explore all of these issues and merely duplicate previously published articles, our aim was to take a novel approach: that is, to step back from these arguments and provide perspective from the vantage point of distance. In the case of trans myocardial revascularization, distance comes both in terms of history and in terms of methodology and knowledge from other fields of research. Historically, innovative methods of myocardial revascularization are by no means uncommon. The first two chapters deal with this historical' perspective.

Author: A.E. Iskandrian
Publisher: Springer Science & Business Media
ISBN: 9401140804
Category : Medical
Languages : en
Pages : 247

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Book Description
AMI E. ISKANDRIAN & ERNST E. VAN DER WALL The first edition of this book was published in 1994. Since then important advances have occurred in the field of myocardial viability. This, coupled with increasing interest by the scientific community in the broader issues of its relevance to patient care, suggested to us the need to write the second edition. We are most fortunate to have the help of a distinguished group of experts who have helped shape the field; we appreciate their commitments and contributions. Almost all chapters have been radically modified. Chapter 1 deals with pathophysiology of myocardial hibernation and stunning; Chapter 2 with apoptosis; Chapter 3 with the role of positron emission tomography; Chapters 4 and 5 with the role of single photon emission computed tomography with thallium-201 and technetium agents, respectively; Chapter 6 with the role of SPECT fatty acid imaging; Chapter 7 with the role of SPECT FDG imaging; Chapter 8 with the role of cardiac catheterization angiography; Chapter 9 with the role of echocardiography; Chapter 10 with the role of magnetic resonance imaging; and Chapter 11 with clinical applications. Finally, Chapter 12 provides a short summary.

Author: Zainul Abedin
Publisher: Springer Science & Business Media
ISBN: 1461546079
Category : Medical
Languages : en
Pages : 577

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Book Description
Accurate diagnosis of arrhythmias is the goal of this volume. Before the clinician can accurately classify the multiple permutations of cardiac rhythm encountered in daily practice, several essential preconditions must be met. At the most basic level, the clinician must know the diagnostic criteria for each rhythm. Without a clear understanding of these criteria, an accurate differential diagnosis is impossible, and without accurate diagnosis, correct intervention is a mere matter of chance. A second precondition of accurate rhythm diagnosis is an understanding of the mechanism of arrhythmias. Not uncommonly, two or more arrhythmic mechanisms coexist, confronting the clinician with a baffling mixture of apparently unrelated complexes and intervals. Without an understanding of the various arrhythmic mechanisms, simple and complex, the tangled skein of data can never be unraveled. Finally accurate arrhythmia diagnosis depends on skill attained through practice. The competent electrocardiographer combines the skills of precise measurement and rational application of logic with broad theoretical knowledge. The pleasure of electrocardiography is seeing through the surface appearance to the inner workings. Interpretation of Cardiac Arrhythmias presupposes no prior knowledge of arrhythmias, and progresses from basic to the complex. The didactic sections focus extensively on the mechanism of arrhythmia, using laddergrams and other diagramatic devices to help the student visualize what is happening with the cardiac conduction system. Extensive self-assessment sections enable students to apply critical skills and test their grasp of the diagnostic criteria.

Author: C. Berul
Publisher: Springer Science & Business Media
ISBN: 9780792378297
Category : Medical
Languages : en
Pages : 396

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Book Description
The molecular basis for atrial fibrillation continues to be largely unknown, and therapy remains unchanged, aimed at controlling the heart rate and preventing systemic emboli with anticoagulation. Familial atrial fibrillation is more common than previously suspected. While atrial fibrillation is commonly associated with acquired heart disease, a significant proportion of individuals have early onset without other forms of heart disease, referred to as "lone" atrial fibrillators. It is also well recognized that atrial fibrillation occurs on a reversible or functional basis, without associated structural heart disease, such as with hyperthyroidism or of atrial fibrillation following surgery. It remains to be determined what percentage in these individuals is familial or due to a genetic predisposition. Mapping the locus for familial atrial fibrillation is the first step towards the identification of the gene. Isolation of the gene and subsequent identification of the responsible molecular genetic defect should provide a point of entry into the mechanism responsible for the familial form and the common acquired forms of the disease and eventually provide more effective therapy. We know that the ionic currents responsible for the action potential of the atrium is due to multiple channel proteins as is electrical conduction throughout the atria. Analogous to the ongoing genetic studies in patients with familial long QT syndrome, it is highly likely that defects in each of these channel proteins will be manifested in familial atrial fibrillation.

Author: Douglas L. Mann
Publisher: Springer Science & Business Media
ISBN: 1461514495
Category : Medical
Languages : en
Pages : 111

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Book Description
Although clinicians have recognized the importance of inflammatory mediators in the pathogenesis of heart disease for well over 200 years, it has taken nearly as many years for clinicians and scientists to focus on the basic biological mechanisms by which inflammatory mediators contribute to the pathogenesis of cardiac disease states. Over the past decade there has been increasing interest in the potential role that inflammatory mediators, play in a variety of cardiac disease states, including chronic heart failure. The Role of Inflammatory Mediators in the Failing Heart provides a state-of-the-art review on inflammatory mediators and the failing heart. This book will serve both as a useful introduction to the field, as well as an update for those interested in the role of inflammatory mediators and the failing heart.

Author: Myrvin H. Ellestad
Publisher: Springer Science & Business Media
ISBN: 9780792373780
Category : Medical
Languages : en
Pages : 200

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Book Description
Since it was introduced less than 100 years ago, analysis of the circulatory response to exercise as a measure of cardiac function has undergone remarkable development. Most recently this approach has incorporated the burgeoning technology of the last half of the 20th century to meet the physiological and diagnostic needs of scientist and clinicians. The ease of administration, economy and abundant data that characterize exercise testing for its relative staying power as the most frequently utilized noninvasive method of cardiovascular evaluation. The basic modalities of exercise electrocardiography of treadmill and bicycle have been extended by noninvasive cardiac imaging techniques, including scintigraphy and echocardiography, that have provided new insights in myocardial function during exertion and pharmacologic stress. At the same time, traditional exercise electrocardiography has also been refined by innovations that have broadened its applications. Exercise Testing: Current Concepts and Recent Advances affords the reader a state-of-the-art presentation of the diverse and expanding methods of exercise testing and their roles in patient management. The contributors to this volume include individuals who have made seminal contributions to the field during the last several decades. Indeed, it is legitimate to designate this group as a `Who's Who of Exercise Testing'. It is our hope that this book will enhance the reader's understanding of contemporary methods of exercise testing, as well as provide a glimpse into future directions of this science, that this knowledge is applied to optimal diagnosis and management of our patients.

Author: R. Masters
Publisher: Springer Science & Business Media
ISBN: 079236130X
Category : Medical
Languages : en
Pages : 202

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Book Description
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.

Author: Lloyd W. Klein
Publisher: Springer Science & Business Media
ISBN: 9780792385097
Category : Medical
Languages : en
Pages : 336

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Book Description
Despite recent advances in the diagnosis and treatment of various cardiac illnesses, including ischemic, valvular and cardiomyopathic disease, the most cost-effective means of employing laboratory testing and treatment modalities remains an issue in most practice settings. With the advent of managed care and vigilant third-party payer evaluation of the use of diagnostic tests and hospital length of stay, the most effective medical and economic method of managing everyday cardiac illness is a question that arises daily in practice. To this end, we have selected well-known and widely published experts in cardiac diagnosis and therapy to develop practical and informative approaches outlining the most cost-effective methods of patient management. The topics include the entire range of cardiac diseases and emphasize the economic impact on decision-making. We develop guidelines and present general strategies for the practicing cardiologist and general internist. Additionally, the editors, who have 10 years of experience in this area, discuss the methods necessary to bring critical pathways and practice guidelines into clinical use. Both hospital and out-patient phases of illness are considered. Special concerns of hospital, private practice managed care and group practice settings are specifically addressed.

Author: James E. Lock
Publisher: Springer Science & Business Media
ISBN: 9780792385974
Category : Medical
Languages : en
Pages : 404

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Book Description
Cardiac catheterization has long been a central diagnostic modality in the evaluation of children, adolescents, and adults with congenital heart disease, and in children with acquired heart disease. Over the past two decades, transcatheter interventions have become equally important in the treatment of pediatric and congenital heart disease. Some transcatheter therapies have become established as the standard of care for congenital cardiovascular anomalies previously managed surgically, others serve to supplement surgery in the integrated management of complex lesions, and still others are in their infancy, as pediatric interventional cardiology continues to advance in step with the broader field of pediatric cardiovascular medicine. Since the previous edition of this book, new technologies and techniques have been introduced to the field of pediatric interventional cardiology, much has been learned about established transcatheter therapies, and there has been a substantial increase in the volume of published data on outcomes of transcatheter procedures in congenital and pediatric heart disease. With increasing experience, the role of interventional catheterization has become solidified as an integral component of the comprehensive management of patients with essentially all forms of congenital heart disease. Cardiac catheterization has also become established as a distinct subspecialty within the discipline of pediatric cardiology, and at many centers has become the purview of cardiologists who have received specialized training in interventional catheterization and whose practice is focused on catheterization. This book is targeted to trainees and established interventional cardiologists alike, and is intended as a comprehensive reference for the clinical practice of diagnostic and interventional cardiology in pediatric and congenital heart disease. In the organization of this book, a combination of procedure-based and problem-based approaches has been employed. The structure of the book has been updated to make it more reader friendly, chapters have been added to address new techniques and problems in the field, and greater emphasis has been placed on evaluation of outcomes of transcatheter interventions in congenital heart disease. Section 1 covers the fundamentals of cardiac catheterization, with chapters devoted to pre-procedure patient evaluation, sedation and anesthesia, vascular access and related issues, catheterization equipment ands its use, hemodynamic evaluation, angiography, radiation and radiation safety, and echocardiography in the catheterization lab. Sections 2 through 4 include procedure-based chapters that are organized according to the technical type of intervention. Section 2 is devoted to transcatheter interventions for obstructive lesions, including valvar stenoses and vascular obstructions. Section 3 includes chapters that cover interventions to close various pathologic intracardiac communications and vascular anomalies. Section 4 includes chapters covering interventions performed to create or enlarge intracardiac communications, as well as other interventions. Section 5 focuses on the applications of catheterization and transcatheter interventions in the evaluation and management of specific patient populations. This problem-based or patient-based focus, which is substantially expanded from the previous edition of the book, reflects the expanding role of catheterization in the comprehensive management of pediatric and congenital heart disease, and addresses emerging applications of transcatheter interventions, including management of the patient receiving extracorporeal circulatory support, hybrid transcatheter-surgical interventions, and prenatal cardiac intervention. Section 6 includes two chapters that cover outcome assessment and regulatory issues pertinent to the pediatric cardiology in general and interventional cardiology in particular.