The Clinical Anatomy Of Coronary Arteries

Considerable advances have been made in cardiology during the last few decades. In particular, there has been great progress in the field of coronary angiography both when combined with, and without, computed tomography (CT) and magnetic reso nance (MR) imaging. These techniques of modern imaging allow the cardiologist and coronary surgeon to study every cardiac structure in detail, both two- and three-di mensionally and from either side, to analyze the movements of the heart and valves, and to observe myocardial circulation and even myocardial metabolic processes. However, coronary heart disease, a multifactorial illness of the coronary vessels, still remains the most common cause of death in developed countries. In addition to the large group of patients suffering from coronary heart disease, there is a smaller group of children and adults who are in need of open heart surgery and,most frequently,valve surgery.Avery small number of individuals suffering from Wolff-Parkinson-White syndrome still await competent surgical intervention. These three groups of patients have in common that, for them, meticulous preop erative diagnostics and preparation for surgery are urgently required. Any open heart surgeon who carri es out procedures in the coronary or interventricular grooves or on the atrial walls of the heart must take the normal and anomalous origins,courses, and terminations of cardiac vessels into consideration. Therefore, with the availability of precise anatomical and physiological data,operation time will be shortened, operative risks will diminish, and the safety of the operation for the patient will be greater.

The magnificent anatomic presentation in this book "The Heart and Cor onary Arteries" has a unique importance for surgeons. It is a fundamental contribution to the anatomy of the heart and great arteries as well, because of the analytical, detailed, and imaginative anatomic approach of the author. While surgery from time to time is influenced by the development of new physiologic principles and techniques, methods of intra- and post-operative support, and new diagnostic methodology, the excellence of its results con tinues to be related primarily to the precision and perfection of the opera tive procedure itself. The operative procedure can be precise and perfect only if it is based upon the surgeon's profound knowledge of normal anatomy, his understanding of the alterations in this normal anatomy by the pathol ogy with which he is dealing, and his ability to use this anatomic informa tion in organizing and effecting his surgical procedure. The cardiac sur geon, therefore, will find great rewards from intense study of this anatomic atlas. The cardiologist, the pediatric cardiologist, the anatomist, the pathol ogist, and students interested in cardiac disease will benefit to almost the same degree from a careful study of this work. May 1975 JOHN W. KIRKLIN, M. D.

Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

In non-fatal cases, cardiovascular diseases are associated with a decreased quality of life as well as a substantial economic burden to society. Most sudden cardiac events are related to the complications of a non-stenosing marginal plaque. For this reason, the ability to properly identify the atherosclerotic plaque with rapid, non-invasive techniques is of utmost clinical interest in diagnostic workup and therapeutic planning of symptomatic patient. Nowadays CT produces high-quality images of the coronary arteries, in addition to defining their location and the extent of the atherosclerotic involvement. This new edition is enriched with two important additions. Firstly, dedicated chapters on intravascular ultrasound (IVUS), catheter angiography, and nuclear imaging have been included, with some discussions on theoretical techniques such as optical coherence tomography (OCT) and magnetic resonance imaging (MRI). Secondly, a completely new section comprising more than 70 clinical cases remarkably expands the horizons reached by the previous edition. This volume provides general practitioners and cardiologists with a basic understanding of the imaging techniques. For radiologists with no direct experience in cardiac imaging, the book serves as an important source of information on coronary pathophysiology and anatomy.