Myocardial Protection

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.

THE LANDMARK GUIDE TO ADULT CARDIAC, CONGENITAL CARDIAC, AND GENERAL THORACIC SURGERY--COMPLETELY UPDATED AND REVISED IN FULL COLOR An essential guide for daily clinical practice and a thorough review for the cardiothoracic boards, Johns Hopkins Textbook of Cardiothoracic Surgery is filled with authoritative guidance on surgical techniques and pre- and postoperative strategies for managing cardiothoracic disease. The content of this trusted classic reflects the rapidly changing field of cardiothoracic surgery. In addition to the basic curriculum required for certification, you will find coverage of advanced concepts, controversial issues, and new technologies. Johns Hopkins Textbook of Cardiothoracic Surgery provides an in-depth look at the full-spectrum of disorders and their surgical and medical management options, including congenital, acquired, and neoplastic diseases. Supporting this detailed coverage is an easy-to-navigate design and step-by-step explanations of the most complex operations. THE SECOND EDITION IS HIGHLIGHTED BY: NEW board review Q&A Ten NEW chapters including: Surgical Therapies for Atrial Fibrillation, Management of Adults with Congenital Heart Disease, and Stem Cells for Cardiac Surgical Disease NEW full-color illustrations An increased number of decision-making flow charts that will prove valuable when preparing for cases and examinations Key Concepts that highlight epidemiology, pathophysiology, clinical features, diagnostic and treatment strategies, and outcomes for each topic NOTE: This book was previously known as the Johns Hopkins Manual of Cardiothoracic Surgery but the second edition has been renamed to better reflect its scope and comprehensive nature.

A critical review of the most up-to-date research on purines and myocardial protection. The role of purines in reversible `myocardial stunning' and irreversible (myocardial infarction) ischemic injury, ventricular arrhythmias, and ischemic preconditioning is discussed in detail, by experts. All reviews address recent and rather controversial issues on purines and myocardial protection. Mechanisms of cardioprotection of exogenous versus endogenous purines are discussed in detail. The contribution of internationally recognized experts in the field of purines and cardiovascular physiology and in myocardial protection makes this a unique and interesting book for clinicians, basic scientists and students.

Over the past ?fty years, advanced techniques and strategies have arisen in the ?eld of myocardial protection. Meticulous trials, focusing on pulmonary protection during heart surgery requiring cardiopulmonary bypass (CPB), have been missing. This te- book is intended to serve as a useful tool to spread information on strategies for lung protection during heart surgery with CPB. Emphasis on pulmonary protection will be turned to lung perfusion as an adjunct for minimizing the deleterious effects of pulmonary ischemia-reperfusion injury in heart surgery. Many renowned authors have contributed by presenting their expe- ence on lung perfusion in basic research and clinical trials. Furthermore, they have enlightened the quality of this textbook with new ideas, concepts, and future perspectives. The scope of this textbook is of interest to different professionals, such as card- vascular surgeons, pulmonary surgeons, transplantation physicians, cardiothoracic anesthesiologists, intensive care physicians, cardiothoracic fellows, radiologists, basic sciences physicians, cardiologists, pulmonary medicine physicians, perfusi- ists, nurses, students, and researchers. This textbook has 7 sections, aimed at addressing general and speci?c aspects of pulmonary protection during heart surgery with CPB. The ?rst section on general concepts provides information about anatomic, physiologic, histologic, molecular, and radiologic considerations regarding the lungs. The second section focuses on ischemia-reperfusion injury and is composed of several interesting chapters, addressing the basic science aspects of pulmonary p- tection, as well as experimental and clinical experiences from different heart surgery centers worldwide.

Although cardiac surgery has made an enormous progress during the last decades, the discipline has to cope with essential changes: Patients are increasingly cared for by cardiologists and therefore referred to the surgeon in a later stage of disease. Consequently, they are more often in an increasingly serious state or in advanced age with significant comorbidities. In order to meet the requirements of these different patient groups, cardiosurgical treatments require special protectional strategies for the heart in order to perform the planned operations safely. This book presents the latest knowledge of modern techniques of myocardial protection taking into consideration the different patient groups and current scientific strategies. Furthermore, it discusses present and future scientific approaches in myocardial protection and preservation.

A complete clinically orientated guide to cardiopulmonary bypass and extracorporeal support for trainee medical and technical personnel in cardiac surgery.

This textbook provides a succinct overview of cardiac surgery, with key concepts being emphasized throughout. An abundance of illustrations, intra-operative photographs, tables as well as information boxes, aids the reader to visualise, grasp and retain difficult concepts. The inclusion of evidence-based approaches to the management of a range of cardiac surgical conditions equips the reader with an understanding of how to overcome a variety of potentially tough clinical challenges. Concise Cardiac Surgery: A Complete Guide comprehensively covers a range of techniques used in cardiac surgery. It is therefore, an ideal resource for the trainee and practising cardiac surgeon seeking a practically focused text detailing how to apply the latest techniques and evidence-based approaches in their day-to-day practice.

Myocardial ischemic syndromes pose a major medical problem and a significant economic health care concern. Reperfusion, although used in the clinical arena as essential to the survival of acutely ischemic heart muscle carries with it the risk of "reperfusion injury". Therefore the salvage of additional myocardium is highly desirable. Over a decade ago, it was shown that whole body heat shock activated a powerful endogenous protective mechanism that significantly improved myocardial salvage following prolonged ischemia and reperfusion injury in the heart. A characteristic feature of this heat shock response was the expression of a family of proteins known as heat shock proteins. Many of these proteins function as molecular chaperones, helping to refold proteins denatured as a consequence of lethal injuries and facilitating the synthesis of new proteins to replace those irreparably damaged. Altered expression of these proteins has been extensively documented in association with a diverse array of diseases such as ischemia and perfusion injury, cardiac hypertrophy, fever, inflammation, metabolic diseases, infection, cell and tissue trauma, aging, and cancer. Interestingly, some studies have now shown a direct correlation of the heat shock proteins produced and the degree of myocardial protection. This book is a thorough description of the current state of knowledge of the mechanisms of heat shock proteins induced cardiac protection at the cellular and molecular level, the controversies in this growing field and the potential of treating ischemic heart disease with overexpression of heat shock proteins in patients. The book will be especially useful for investigators interested in studying tissue injury and its protection with the overexpression of heat shock proteins.