Mechanical cardiovascular assist devices must be properly designed to avoid damage to the blood they contact. The factors that affect the hemocompatibility of a cardiovascular assist device include three major non-physiological components – the material, fluid flow paths, and flow related stresses, - as well as the device interaction with the native vasculature. Furthermore, the interaction of the device with the blood is not static. Foreign surfaces activate blood components including platelets, leukocytes and the coagulation cascade. Thrombus formation on the surface of the device can alter the fluid dynamics in a manner that causes erythrocyte damage ranging from significant hemolysis to sub-lethal trauma that can take many days to weeks to develop into a significant clinical problem. This sub-lethal blood trauma is not easily detectable without special equipment, which is typically unavailable in routine clinical practice. Surveillance for blood damage is often sub-optimal in the clinical setting, but once clinically relevant hemolysis occurs, crucial decisions - device removal, replacement, or additional medical therapies including surgery or plasmapheresis - that take into account the risk/benefit of intervention must be quickly evaluated. The various preclinical designs and testing, surgical considerations, available surveillance techniques, and clinical consequences will be discussed using recent and historical case reports to highlight key points.

Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy.

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

Mechanical Circulatory and Respiratory Support, Second Edition, continues to provide a comprehensive overview of the past, present and future development of mechanical circulatory and respiratory support devices. This new edition provides an update on the field while also introducing new elements within the field such as ex-vivo perfusion, devices for HFpEF, design for manufacture, oxygenator design, and more content on route to market. Chapters from over 60 internationally-renowned experts focuses on the entire life-cycle of mechanical circulatory and respiratory support – from the descent into heart and lung failure, alternative medical management, device options, device design, implantation techniques, complications and medical management of the supported patient, patient-device interactions, cost effectiveness, route to market and a view to the future. This second edition is a useful resource for biomedical engineers and clinicians who are designing new mechanical circulatory or respiratory support devices, while also providing a comprehensive guide of the entire field for those who are already familiar with some areas and want to learn more. Reviews of the most cutting-edge research are provided throughout each chapter, along with guides on how to design new devices and which areas require specific focus for future research and development. - Presents an engineering pathway to develop the most advanced medical devices - Features a clinical summary of how to select the right patients and treat them optimally while supported with these devices - Includes a detailed path to market for those developing new devices in this field

The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

An all-in-one guide to mechanical assist devices for the treatment of heart failure This complete guide addresses all of the clinical scenarios encountered by the health care team during the pre-operative, intra-operative, and post-operative periods following device implantation. In addition, it outlines the specific attributes of various technologies that are currently utilized by clinicians, giving you a practical view of how the latest devices work. You’ll also find a mini-catalog of the spectrum of current devices, complete with their technical and clinical specifications. Drawing on the latest published data and the combined global expertise of a renowned author team, Mechanical Circulatory Support puts the field’s most essential perspectives right at your fingertips. FEATURES: The unmatched mechanical circulatory device sourcebook, covering the physiological, technical, regulatory, and clinical aspects of ventricular assist devices Full-color presentation features a wide range of photographs, radiographs, tables, and clearly labeled clinical and schematic illustrations Essential insights into the physiology of heart failure, which provides a basic foundation of knowledge for understanding the role of mechanical circulatory assistance in the management of heart failure Logical two-part organization consisting of: Clinical Considerations in mechanical circulatory support, including device history/development and indications for device therapy; perioperative management; complications; and special considerations (use in infants/children, pulmonary hypertension during LVAD support, and more) Device-Specific Considerations, which provides a mini-catalog of manufacturer’s devices—-from short-term devices to long-term continuous flow devices—-and highlights technical and clinical specifications for each product Guide to appropriate device selection using a simplified framework in an industry that produces an increasing array of short- and long-term therapies Helpful chapter introductions provide essential background information that places each chapter topic in its proper clinical and technical context Conclusions at the end of each chapter offer a concise summary of chapter material Full chapter-ending references provide opportunities for further research

Rotary blood pumps increasingly are being used in open heart surgery and in assisted circulation for patients with heart disease. These rotary devices include vortex (centrifugal) and axial pumps, which can be utilized in conditions where the use of conventional pulsatile pumps would entail problems of cost and size. Rapid progress is now being made in developing new devices for controlling blood flow within the heart and great vessels as well as extracorporeally for use in coronary and intensive care units and, in the future, for long-term use. This book provides information on the physiology of nonpulsatile circulation, the development of rotary pump engineering, and the clinical application of rotary blood pumps. It also presents an overview of future developments in this important field.

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.

Patients with cardiac conditions routinely present for noncardiac surgeries, requiring special protocols for perioperative assessment and management by the anesthesiologist. Essentials of Cardiac Anesthesia for Noncardiac Surgery: A Companion to Kaplan's Cardiac Anesthesia provides current, easily accessible information in this complex area, ideal for general anesthesiologists and non-cardiac subspecialists. From preoperative assessment through postoperative care, this practical reference covers all perioperative approaches to today's patients with cardiac conditions. - Provides guidance on the anesthetic diagnosis and management of the full range of cardiac lesions, helping minimize adverse outcomes and reduce complications for patients with common, complex, or uncommon cardiac conditions. - Includes complete coverage of echocardiography and current monitoring techniques needed for thorough perioperative assessment – all from the anesthesiologist's perspective. - Discusses safe and effective perioperative anesthetic management of patients presenting with advanced levels of cardiac care such as drug-eluting stents, multiple antiplatelet drugs, ventricular assist devices, multiple drugs for end-stage heart failure, and implanted electrical devices that produce cardiac resynchronization therapy, as well as patients with complicated obstetric problems or other significant cardiovascular issues. - Features a concise, easy-to-navigate format and Key Points boxes in each chapter that help you find answers quickly.