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Minimally Invasive Cardiac Surgery FREE TO VIEW

Said Yassin, MD
Chest. 2005;128(5):3777-3778. doi:10.1378/chest.128.5.3777
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By Daniel J. Goldstein and Mehmet C. Oz, eds. Totowa, NJ: Humana Press Inc., 2004; 496 pp; $165.00

Since heart surgery became a possibility 50 years ago, major evolution has taken place in the way that we treat what was once an incurable and fatal category of disease. Within this relatively short time frame, we have accumulated substantial knowledge about cardiovascular physiology and pathology, and developed efficient methods to meet the cellular metabolic needs of the heart and all other organs during surgery on the heart itself. Our current state of knowledge allows operations for cardiac revascularization and valve replacement to be performed over one million times per year, worldwide, with minimal risks and major favorable impact on outcome. Hot on the heals of the preeminence of cardiac surgery, a whole new panoply of therapeutic catheter-based techniques has emerged, making great strides toward effective, less invasive ways to treat cardiovascular disease and challenging us to further refine the way we do invasive cardiac surgery. The goal has been, and always will be, to provide the best operation with the longest-lasting benefit while subjecting the patient to the least possible trauma. The surgical community, as always rising to the challenge, has consequently introduced new techniques to eliminate or modify some of the maneuvers associated with morbidity (aortic manipulation, sternotomy, and cardiopulmonary bypass) and still perform the classical operations that yield proven and reproducible outcomes.

With this second edition of Minimally Invasive Cardiac Surgery, Doctors Goldstein and Oz have eloquently filled a needed niche by gathering together descriptions of the newest pioneering technologies in this field. Their text covers most new developments, including minimally invasive direct coronary artery bypass, off-pump coronary artery bypass grafting, off-pump totally endoscopic coronary artery bypass grafting, endoscopic conduit harvest, robotic valve surgery, percutaneous valve repair, ablation therapy, and novel anastomotic devices, with contributions from notable experts such as Mohr, Chitwood, Califiore, and others. The multiple authorship format offers the reader a wide-ranging review of techniques and opinions from different centers, especially important in a new field such as this where often exists a lack of consensus with respect to technological details. For each procedure, the authors provide an historical background along with an overview of the scientific basis, clinical results, and comparative studies. The text is supported by clear diagrams, tables, and an excellent bibliography. One must also bear in mind, however, that any text addressing rapidly evolving technologies may unavoidably lag behind the newest data. For example, the St. Jude symmetry automatic anastomosis device was withdrawn from the market after concerns about long-term patency, and newer techniques have emerged such as thoracoscopic ablation therapy for atrial fibrillation, neither of which made it into this edition of the book.

Minimally Invasive Cardiac Surgery is directed to cardiac surgery residents, fellows, and practicing surgeons. Cardiac surgeons will find it of great utility for developing and enhancing skills in these new techniques, since it provides one-stop shopping for the comprehensive technical details of most procedures along with clear pictures and descriptions of alternative devices available in the market. It will doubtless also serve as a valuable teaching tool and reference for resident and fellow education.




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