Each year, over 250,000 heart valve repair and heart valve replacement operations are performed for conditions including stenosis, prolapse, insufficiency, aneurysm, Tetralogy of Fallot and regurgitation. However, most patients and caregivers surveyed felt their expectations were mismanaged - both before and after surgery. The Patient's Guide to Heart Valve Surgery was written by Adam Pick, a double heart valve surgery patient, to address this troubling issue and prepare the patient and caregiver for the challenges and opportunities of valve surgery - from diagnosis through recovery.

A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.

Introductory Chapter: Dedicated Initial Giants Breaking the Barriers to Successful Cardiac Transplantation Therapy.

The 5th International Symposium on Artificial Heart and Assist Devices was held in Tokyo on January 26 - 27, 1995, bringing together leading researchers and specialists from all over the world. The proceedings of the symposium presents the newest ideas and approaches in the field, and will be of special interest and relevance to all who are concerned with artificial organs, cardiovascular surgery, organ transplantation, biomaterials, and related disciplines. Reflecting the content of the symposium, the major topics in this volume include biocompatible material development, clinical use of assist devices, completely implantable devices, and heart transplantation. These are presented in the two main divisions of the book: The first consists of eight lectures by leading researchers, world-renowned in the field of the artificial heart. The second comprises more than 50 papers on such subjects as biomaterials, research and development of ventricular assist systems and the total artificial heart, and their use as a bridge to heart transplantation. An additional, special feature of the book is the inclusion of descriptions of exhibitions at the symposium, with photographs of all artificial heart devices and systems displayed by major laboratories and companies from around the world.

Heart transplantation remains one of the major scientific achievements of twentieth century medicine. During the past four decades, it has evolved from an unproven experimental surgical technique to the most effective form of therapy for refractory end-stage heart disease. It has captured the public's imagination and expanded our understanding of fundamental immunologic mechanisms that are responsible for cellular and humorally-mediated immunity. Despite its successes, many clinical and scientific problems remain. One or more bouts of acute cellular or humoral (vascular) rejection will occur in over 75% of transplant recipients despite current immunosuppressive strategies. Further, rejection directly results in approximately 20% of post-transplant deaths and is believed to play a major role in the development of late allograft dysfunction and coronary vasculopathy. This book by international experts in the fields of transplantation medicine, immunobiology and cardiac imaging provides the reader with an up-to-date, consise summary of the latest developments in the diagnosis and treatment of acute cardiac rejection. It is axiomatic that a more complete understanding of the pathogenic processes involved in rejection will ultimately lead to its prevention. This volume will be useful to transplant cardiologists, cardiovascular surgeons, cardiac pathologists and transplant scientists who seek to prolong the lifespan and improve the quality of life of their transplant recipients.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Can we save ourselves, or do we rely on others to do it? Is what we believe always the truth?

Cardiovascular disease is the major cause of morbidity and mortality worldwide. While the past 40 years have brought major progress in cardiac valve repair and replacement, there remain large patient populations that do not receive such therapies. This, in turn, implies a great need for future basic, applied, and clinical research and, ultimately, therapeutic developments. Heart Valves is a state-of-the-art handbook dedicated to: 1) cardiac valve anatomy, 2) models for testing and research methods; 3) clinical trials; and 4) clinical needs and applications.

An excellent resource for practitioners who participate in the care of transplant patients, this comprehensive new second edition covers all aspects of heart and lung transplantation. Each area of the field is fully addressed, with documentation and practical points for patient management provided throughout. An especially notable feature of this new edition is the greatly expanded coverage of lung transplantation, with every chapter rewritten to reflect changes to current information in the field. Complete coverage of all aspects of heart and lung transplantation, including evaluation and management of transplant patients, anesthetic and operative techniques, postoperative care, biopsy techniques, immunosuppressive management, long-term management, and pediatric transplantation. Thorough discussions of programmatic issues, donor evaluation and graft preservation, morbidity associated with transplantation, and future implications. Contributions from renowned experts, many from Johns Hopkins University and Stanford University. Includes two new editors: Edward Kasper, MD and James Theodore, MD. Offers significantly expanded coverage on lung transplantation, sections on single lung transplantation, current rejection management, new operative techniques, and effective patient care. Presents several new chapters including: Medical and Surgical Alternatives to Cardiac Transplantation (Ch. 8), Living Related Lung Transplantation (Ch. 43), Lung Pathology (Ch. 28), Immunosuppressive Therapy in the 21st Century (Ch. 48), and Management of Congestive Heart Failure in the 21st Century (Ch. 49). Covers new information on quality of care, circulatory support and Mechanical Circulatory Assistance Prior to Heart Transplantation (Ch. 12).